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Infection data may not be comparable across hospitals, study shows
Date:9/18/2012

A new study has found that some kinds of infection data may not be comparable across hospitals, and may not be suitable for use as a performance measure.

Published in the leading US policy journal Milbank Quarterly, the research found huge variability in how English hospitals collected, recorded and reported their rates of central line infections to a patient safety programme. The study was funded by the Health Foundation, a major UK charitable foundation aiming to improve quality of care.

"Central line infections occur in tubes used in treating seriously ill patients. These infections are largely preventable, and hospitals need to be able to monitor how well they are doing in controlling them," said study author Professor Mary Dixon-Woods from University of Leicester. "But because hospitals don't use the same methods to generate the data, using their reported rates to produce league tables of performance or to impose financial sanctions, as happens in the US, is probably not appropriate."

Researchers found most variability arose for what they called "mundane" reasons. These included challenges in setting up data collection systems, different practices in sending blood samples for analysis, and difficulties in deciding the source of infections.

"Although hospitals were given clear, standardised definitions to use, many laboratories did not have the tools to make the most definitive assessment of where infections were coming from in the patient's body," said Julian Bion, Professor of Intensive Care Medicine at University of Birmingham. "That meant they had to use clinical judgement to decide whether any infection was due to a central line. Once you are relying on judgement, you will get variation."

The study dismissed 'gaming' as the explanation for the variations the researchers found. "Some previous studies have reported deliberate manipulation of performance data to 'look good'", said Professor Dix
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Contact: Professor Mary Dixon-Woods
md11@le.ac.uk
44-011-622-97262
University of Leicester
Source:Eurekalert  

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