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Influence of State Laws Mandating Reporting of Healthcare-Associated Infections: The Case of Central Line–Associated Bloodstream Infections

  • Amy L. Pakyz (a1) and Michael B. Edmond (a2)

To evaluate the impact of state laws on reporting of healthcare-associated infections on central line-associated bloodstream infection (CLABSI) rates.


Retrospective, cross-sectional study.


Hospital-level administrative and Hospital Compare data were collected on University HealthSystem Consortium hospitals. An ordered probit regression model assessed the association between state legislation and CLABSI standardized infection ratio (SIR). The main independent variable was a state legislation variable concerning 3 legal requirements (data submission, reporting of data to the public, inclusion of facility identifiers in public reports) and was coded for hospitals accordingly located in a state that did not have CLABSI reporting, located in a state that had CLABSI reporting legislation and met 3 legal requirements, or located in a state that had CLABSI reporting but did not meet the 3 legal requirements. A secondary analysis ascertained whether the mean state SIR values differed among the 3 legislation groups.


There were 159 hospitals included; 92 were located in states that had CLABSI reporting and met 3 requirements, 33 were located in states that had reporting but did not meet the 3 requirements, and 34 were in states that had no legislation. There was no effect of state legislation group on CLABSI SIR. There were no significant differences in the mean state CLABSI SIRs among the legislation groups.


In this sample of academic medical centers, there was no evidence of an effect of state HAI laws on CLABSI occurrence. The impact of state legislation may be lessened by other CLABSI prevention initiatives.

Corresponding author
Virginia Commonwealth University School of Pharmacy, 410 North 12th Street, P.O. Box 980533, Richmond, VA 23298 (
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11. P Pronovost , D Needham , S Berenholtz , et al.An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006;355:27252732.

12. GM Lee , K Kleinman , SB Soumerai , et al.Effect of nonpayment for preventable infections in U.S. hospitals. N Engl J Med 2012; 367:14281437.

14. LA Backman , R Melchreit , R Rodriguez . Validation of the surveillance and reporting of central line-associated bloodstream infection data to a state health department. Am J Infect Control 2010;38:832838.

15. MY Lin , B Hota , YM Khan , et al.Quality of traditional surveillance for public reporting of nosocomial bloodstream infection rates. JAMA 2010;304:20352041.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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