权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Use of electronic data to improve risk adjustment for hospital infection rates

利用电子数据改进医院感染率的风险调整

基本信息

批准号：
9052713
负责人：
ANTHONY D HARRIS
金额：
$ 25.44万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-01 至 2017-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9052713
关键词：
Use electronic data improve risk

项目摘要

DESCRIPTION (provided by applicant): Healthcare-associated infections including central-line associated bacteremias and surgical site infections increase patient morbidity and mortality. Most states across the United States are requiring hospitals to publicly report healthcare-associated infection rates. Proper risk adjustment adjusts for patient factors without controlling for differences in the effectiveness of care enabling consumers and healthcare maintenance organizations to be informed purchasers of healthcare. Numerous prominent organizations and authors agree that the current method of risk adjustment for healthcare-associated infections is sub-optimal. The current knowledge as to which patient comorbid conditions can be used for risk-adjustment is not known. Our long- term goal is to use electronic data to identify risk factor for healthcare-associated infections that can be used for accurate risk adjustment. The overall objective of this application is to determine which comorbid conditions can be used for risk adjustment for central-line associated bacteremia and surgical site infection. Our central hypothesis is that comorbid conditions identified by ICD-9 codes or admission medications that are easily electronically-available by hospital across the United States can be used to better risk-adjust healthcare- associated infection rates. We plan to test our central hypothesis and, thereby, accomplish the objective of this application by pursuing the following two specific aims: Aim 1. Perform a cohort study of adult patients with central venous catheters across greater than 20 hospitals to determine which electronically-obtained comorbidities are risk factors for central-line associated bacteremia (CLABSI). Aim 2. Perform a cohort study of adult patients who underwent surgery across greater than 20 hospitals to determine which electronically- obtained comorbidities are risk factors for surgical site infection. Sites will be recruited as par of an arrangement between Premier Inc. and the University of Maryland. The advantage of this agreement is that it will allow us to recruit a large number of sites and perform the study in a short time period and in a cost- effective fashion. The proposed work will be significant because it will determine whether easily-obtainable electronic data on patient comorbid conditions can be used to risk adjust nationally-reported surgical site infection rates and central-line associated infection rates. The proposed research is innovative, in our opinion, because: a) it explores the use of patient comorbid conditions as risk factors and risk adjustment variables; and b) it explores variables that are easily obtained by electronic sources, making them potentially very easy to use for risk adjustment in national reporting c) it uses a large number of hospitals.

描述（由申请方提供）：医疗保健相关感染，包括中心静脉导管相关细菌感染和手术部位感染，会增加患者发病率和死亡率。美国大多数州都要求医院公开报告与医疗保健相关的感染率。适当的风险调整针对患者因素进行调整，而不控制护理有效性的差异，从而使消费者和医疗保健维护组织能够被告知医疗保健的购买者。许多著名组织和作者一致认为，目前对卫生保健相关感染进行风险调整的方法是次优的。目前尚不清楚哪些患者合并症可用于风险调整。我们的长期目标是使用电子数据来识别可用于准确风险调整的医疗保健相关感染的风险因素。本申请的总体目的是确定哪些共病可用于中心静脉导管相关菌血症和手术部位感染的风险调整。我们的中心假设是，通过ICD-9代码识别的合并症或美国各地医院容易通过电子方式获得的入院药物可用于更好地调整医疗保健相关感染率的风险。我们计划测试我们的中心假设，从而通过追求以下两个具体目标来实现本申请的目标：目标1。对超过20家医院的中心静脉导管成人患者进行队列研究，以确定哪些电子获得的合并症是中心静脉导管相关菌血症（CLABSI）的风险因素。目标二。对超过20家医院接受手术的成人患者进行队列研究，以确定哪些电子获得的合并症是手术部位感染的风险因素。根据Premier Inc.和马里兰州大学。该协议的优势在于，它将使我们能够招募大量研究中心，并在短时间内以具有成本效益的方式进行研究。拟议的工作将是重要的，因为它将确定是否可以使用容易获得的患者共病情况的电子数据来调整国家报告的手术部位感染率和中心线相关感染率的风险。在我们看来，拟议的研究是创新的，因为：a）它探索了使用患者共病状况作为风险因素和风险调整变量;和B）它探索了容易通过电子来源获得的变量，使它们可能非常容易用于国家报告中的风险调整c）它使用了大量的医院。