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Hospital-acquired UTIs rarely reported in data used to implement penalties
Date:9/5/2012

ANN ARBOR, Mich. Aiming to cut expenses and improve care, a 2008 Medicare policy stopped paying hospitals extra to treat some preventable, hospital-acquired conditions including urinary tract infections (UTIs) in patients after bladder catheters are placed.

But a statewide analysis by the University of Michigan shows there was very little change in hospital payment due to removing pay for hospital-acquired catheter-associated UTIs. For all adult hospital stays in Michigan in 2009, eliminating payment for this infection decreased hospital pay for only 25 hospital stays (0.003 percent of all stays). This is in great contrast to the large savings anticipated, given that this condition accounts for nearly one third of all hospital-acquired infections.

The reason, U-M authors say, is that the "no-pay" policy uses billing data that is inaccurate for identifying such complications.

The findings were published in the Annals of Internal Medicine, alongside an editorial that emphasizes the national policy implications of the U-M findings. U-M's analysis, the editorial says, argues that careful dataset selection is crucial when used to measure and penalize hospital performance.

"We think the policy was well intended but its financial savings from non-payment for catheter-associated UTI are negligible because of the data used to implement the policy," says lead author Jennifer Meddings, MD, MSc, an assistant professor in the Department of Internal Medicine, Division of General Medicine at U-M Medical School.

The problem, authors say, is that the policy relies on claims data previously used only for billing but multiple billing codes must be listed correctly to indicate that a UTI is due to a catheter and occurred only after admission to the hospital. As a result, most cases are listed as simple UTIs and hospitals continue receiving payment as usual.

"If the cases you wish to penalize are not docum
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Contact: Beata Mostafavi
bmostafa@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert  

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