Changes in the Characteristics of Hospitals Participating in the National Healthcare Safety Network (NHSN), 2008–2018

Abstract

Background: The NHSN is the nation’s most widely used healthcare-associated infection surveillance system. Nearly all acute-care hospitals reporting to the NHSN do so in fulfillment of state mandates and/or as required for participation in the CMS Quality Reporting program, since 2011. All NHSN-participating acute-care hospitals (ACHs) reporting in the Patient Safety Component are required to complete an annual survey and to self-report on the hospital’s general characteristics, including hospital size and type, and patient volume. Due to the compulsory nature of the survey, the NHSN receives nearly a 100% completion rate each year. Furthermore, hospital-level characteristics are often used by the CDC to develop risk-adjusted summary measures and national benchmarks. This study is the first to evaluate ACH characteristics over an 11-year period. Methods: All ACHs that completed an annual survey during 2008–2018 were included. The data were divided into subsets to evaluate consistent reporters, defined as facilities that were enrolled in 2008 and completed surveys through 2018. Medical teaching status is defined as a facility that trains either medical students, nursing students, residents and fellows. Medical teaching status is grouped into 3 categories: (1) undergraduate facility that trains medical school students, (2) graduate facility that trains residents or fellows, and (3) major facility that trains both medical and residents or fellows. We used univariate analyses to assess characteristics of acute-care hospitals (ACHs). Results: Overall, the number of ACHs enrolled in the NHSN increased by 119%, from 1,772 in 2008 to 3,883 in 2018. More general acute-care hospitals (89%) were enrolled than all other facility types, with women’s and children’s hospitals were the least frequently enrolled (0.34%). Hospitals with any level of medical teaching status, increased from 38.5% in 2008 to 60% in 2018 (Fig. 1). We observed a modest reduction in the median hospital bed size of 20 beds. When reviewing hospital bed size by category, ACHs with 51–200 beds made up the largest proportion of hospitals and the number of hospitals within this bed size category has remained above 1,500 since 2010. Conclusions: Among all ACHs, the proportion of hospitals affiliated with a medical school increased over the 10-year period. Although hospitals with a major teaching status had been steadily increasing, there were more hospitals using this designation after 2013. Despite the increase in the number of hospitals reporting to NHSN, since 2011, the proportion of hospitals within each bed size category has seen minimal change.

Funding: None

Disclosures: None