Hospital-Acquired Condition Reduction Program Is Not Associated With Additional Patient Safety Improvement
Hospital-Acquired Condition Reduction Program Is Not Associated With Additional Patient Safety Improvement
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DOI：
10.1377/hlthaff.2018.05504
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发表时间：
2019-11-01
期刊：
影响因子：
9.7
通讯作者：
Ryan, Andrew M.
中科院分区：
文献类型：
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作者：
Sheetz, Kyle H.;Dimick, Justin B.;Ryan, Andrew M.
2013年，医疗保险和医疗补助服务中心宣布，将通过医院获得的条件减少计划，开始对医院获得性疾病发生率最高的医院征收罚款。该计划是否在改善患者安全方面取得了成功，尚未进行独立评估。我们使用了来自密歇根州一家大型外科协作体的2010-18年医院获得性疾病比率的临床登记数据来评估这项政策的影响。虽然所有此类情况的比率从计划前的每千人133.4人下降到计划后的122.2人，但非针对性措施的改善幅度更大。我们的结论是，除了现有的趋势外，该计划并没有改善密歇根州的患者安全。这些发现引发了人们对该计划是否会像预期的那样改善患者安全的疑问。
In 2013 the Centers for Medicare and Medicaid Services announced that it would begin levying penalties against hospitals with the highest rates of hospital-acquired conditions through the Hospital-Acquired Condition Reduction Program. Whether the program has been successful in improving patient safety has not been independently evaluated. We used clinical registry data on rates of hospital-acquired conditions in 2010-18 from a large surgical collaborative in Michigan to estimate the impact of the policy. While rates of all such conditions declined from 133.4 per 1,000 discharges in the pre-program period to 122.2 in the post-program period, greater improvements were observed for nontargeted measures. We conclude that the program did not improve patient safety in Michigan beyond existing trends. These findings raise questions about whether the program will lead to improvements in patient safety as intended.