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The impact of measurement changes on evaluating hospital performance: The case of catheter-associated urinary tract infections

Published online by Cambridge University Press:  16 September 2019

Heather E. Hsu*
Affiliation:
Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
Rui Wang
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
Maximilian S. Jentzsch
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
Kelly Horan
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
Robert Jin
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts
Donald Goldmann
Affiliation:
Institute for Healthcare Improvement, Boston, Massachusetts
Chanu Rhee
Affiliation:
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
Grace M. Lee
Affiliation:
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
*
Author for correspondence: Heather Hsu, MD, MPH, Email: heather.hsu@bmc.org

Abstract

Catheter-associated urinary tract infections in 592 hospitals immediately declined after federal value-based incentive program implementation, but this was fully attributable to a concurrent surveillance case definition revision. Post revision, more hospitals had favorable standardized infection ratios, likely leading to artificial inflation of their performance scores unrelated to changes in patient safety.

Type
Concise Communication
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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Footnotes

a

Senior authors of equal contribution.

References

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