Identification of Hospital-Acquired Catheter-Associated Urinary Tract Infections From Medicare Claims

Zhan, Chunliu; Elixhauser, Anne; Richards, Chesley L.; Wang, Yun; Baine, William B.; Pineau, Michael; Verzier, Nancy; Kliman, Rebecca; Hunt, David

doi:10.1097/mlr.0b013e31818af83d

Cited by 51 publications

(42 citation statements)

References 17 publications

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“…Some billing metrics have provided an efficient means of assessing and comparing quality across large populations, particularly for surgical site infections, [8][9][10] whereas other metrics using claims data have been found to be imprecise and lacking validity when compared with clinical data. [11][12][13][14][15][16][17][18] Although claims and administrative data have been used in the past for quality metric assessment, the 2008 CMS HAC payment policy was one of the first largescale efforts by a national payer in the United States to link payment and quality.…”

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confidence: 99%

Impact of the Centers for Medicare and Medicaid Services Hospital-Acquired Conditions Policy on Billing Rates for 2 Targeted Healthcare-Associated Infections

Kawai

Calderwood

Jin

et al. 2015

Infect. Control Hosp. Epidemiol.

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confidence: 99%

Impact of the Centers for Medicare and Medicaid Services Hospital-Acquired Conditions Policy on Billing Rates for 2 Targeted Healthcare-Associated Infections

Kawai

Calderwood

Jin

et al. 2015

Infect. Control Hosp. Epidemiol.

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“…For VTE, we used the combined ICD-9-CM codes 415. 3 12 who first identify patients undergoing major surgery as a proxy for undergoing a catheterization procedure and then identify urinary tract infection (UTI) by using 16 ICD-9-CM codes. They found that major surgery codes were more sensitive at identifying catheter use (sensitivity 47.8%, PPV 75.3%) than catheter codes (sensitivity 1.5%, PPV 78.2%).…”

Section: Identification Of Hospital-acquired Condition Casesmentioning

confidence: 99%

Costs of Venous Thromboembolism, Catheter-Associated Urinary Tract Infection, and Pressure Ulcer

et al. 2015

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OBJECTIVE: To estimate differences in the length of stay (LOS) and costs for comparable pediatric patients with and without venous thromboembolism (VTE), catheter-associated urinary tract infection (CAUTI), and pressure ulcer (PU). METHODS:We identified at-risk children 1 to 17 years old with inpatient discharges in the Nationwide Inpatient Sample. We used a high dimensional propensity score matching method to adjust for case-mix at the patient level then estimated differences in the LOS and costs for comparable pediatric patients with and without VTE, CAUTI, and PU.RESULTS: Incidence rates were 32 (VTE), 130 (CAUTI), and 3 (PU) per 10 000 at-risk patient discharges. Patients with VTE had an increased 8.1 inpatient days (95% confidence interval [CI]: 3.9 to 12.3) and excess average costs of $27 686 (95% CI: $11 137 to $44 235) compared with matched controls. Patients with CAUTI had an increased 2.4 inpatient days (95% CI: 1.2 to 3.6) and excess average costs of $7200 (95% CI: $2224 to $12 176). No statistical differences were found between patients with and without PU. CONCLUSIONS:The significantly extended LOS highlights the substantial morbidity associated with these potentially preventable events. Hospitals seeking to develop programs targeting VTE and CAUTI should consider the improved turnover of beds made available by each event prevented. WHAT'S KNOWN ON THIS SUBJECT:In adults, there is significant increased length of stay, cost, and/or resource use associated with hospitalacquired conditions. Less is known about the epidemiology and impact of many hospitalacquired conditions in pediatric populations. WHAT THIS STUDY ADDS:We find increased pediatric length of stay and costs due to venous thromboembolism and catheter-associated urinary tract infections. This is essential information for hospital administrators and safety departments who are planning interventions to reduce harm associated with these hospital-acquired conditions.

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“…Several studies have investigated the accuracy of structured administrative data such as the World Health Organization's (WHO) International Classification of Diseases, Ninth Revision (ICD-9) billing codes when identifying patient cohorts [3][4][5][6][7][8][9][10][11]. Extracting structured information using ICD-9 codes has been shown to have good recall, precision, and specificity [3,4] when identifying distinct patient populations.…”

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confidence: 99%

Improving Patient Cohort Identification Using Natural Language Processing

Sarmiento

Dernoncourt

2016

Secondary Analysis of Electronic Health Records

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Identification of Hospital-Acquired Catheter-Associated Urinary Tract Infections From Medicare Claims

Abstract: The validity in identifying urinary catheter use and CAUTIs from Medicare claims is limited, but will be increased substantially upon addition of a POA indicator.

Cited by 51 publications

References 17 publications

Impact of the Centers for Medicare and Medicaid Services Hospital-Acquired Conditions Policy on Billing Rates for 2 Targeted Healthcare-Associated Infections

Impact of the Centers for Medicare and Medicaid Services Hospital-Acquired Conditions Policy on Billing Rates for 2 Targeted Healthcare-Associated Infections

Costs of Venous Thromboembolism, Catheter-Associated Urinary Tract Infection, and Pressure Ulcer

Improving Patient Cohort Identification Using Natural Language Processing

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