The Medicare policy of payment adjustment for health care-associated infections: perspectives on potential unintended consequences.
The Medicare policy of payment adjustment for health care-associated infections: perspectives on potential unintended consequences.
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DOI：
10.1177/1077558711413606
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发表时间：
2012-02
期刊：
影响因子：
--
通讯作者：
Lee G
中科院分区：
文献类型：
--
作者：
Hartmann CW;Hoff T;Palmer JA;Wroe P;Dutta-Linn MM;Lee G
2008 年，医疗保险和医疗补助服务中心推出了一项新政策，针对入院时未出现的医疗保健相关感染 (HAI) 调整向医院支付的费用。对美国 36 名医院感染预防专家的采访探讨了这些主要利益相关者对当前政策潜在的意外后果的看法。使用迭代编码过程对响应进行分析，其中根据数据开发主题。参与者对政策意外影响的描述主要围绕三个主题。结果表明，该政策更加关注目标医院感染，并对医院工作人员产生了影响；随后发生的系统变化相对较少。如果医院不认识到潜在的时间和资源差距并做出反应，该政策的一些后果可能会对医院感染率产生不良影响，例如感染预防人员投入到政策中以外的医院感染的时间较少，或者实施预防活动的时间较少。
In 2008, the Centers for Medicare & Medicaid Services introduced a new policy to adjust payment to hospitals for health care-associated infections (HAIs) not present on admission. Interviews with 36 hospital infection preventionists across the United States explored the perspectives of these key stakeholders on the potential unintended consequences of the current policy. Responses were analyzed using an iterative coding process where themes were developed from the data. Participants’ descriptions of unintended impacts of the policy centered around three themes. Results suggest the policy has focused more attention on targeted HAIs and has affected hospital staff; relatively fewer systems changes have ensued. Some consequences of the policy, such as infection preventionists having less time to devote to HAIs other than those in the policy or having less time to implement prevention activities, may have undesirable effects on HAI rates if hospitals do not recognize and react to potential time and resource gaps.
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