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National Claims-Based Quality Measures for Surgical Site Infections

国家基于索赔的手术部位感染质量措施

基本信息

批准号：
9060246
负责人：
Richard Platt
金额：
$ 46.5万
依托单位：
HARVARD PILGRIM HEALTH CARE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-07-01 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9060246
关键词：
National Claims Based Quality Measures

项目摘要

DESCRIPTION (provided by applicant): The Agency for Healthcare Research and Quality (AHRQ), the Centers for Disease Control and Prevention (CDC), and the Centers for Medicare and Medicaid Services (CMS) have all expressed interest in developing validated quality measures for inter-hospital comparisons of healthcare associated infections, including surgical site infections (SSIs). AHRQ's claims-based quality indicators have been applied to administrative data collected through the Healthcare Cost and Utilization Project. Medicare has begun implementation of a value-based purchasing program which will include deep incisional and organ/space SSIs reported by hospitals using the CDC's National Healthcare Safety Network (NHSN). Hospitals reporting higher SSI risks will receive lower reimbursement. Thus, there is a need for improved surveillance and validated quality measures targeting high-risk surgeries, both in major surgical centers and in hospitals with lower procedure volumes. Claims data have been shown to provide more standardized and comprehensive capture compared to traditional SSI surveillance by hospital infection control programs. We propose to expand our prior work on the use of claims data for SSI surveillance by targeting procedures mandated by states for public reporting and proposed for value-based purchasing by CMS. We will 1) extend our previously successful claims-based surveillance following coronary artery bypass graft (CABG) surgery and hip arthroplasty to identify hospitals with an unusually high risk of SSI following knee arthroplasty, another high volume and high cost procedure, 2) identify and validate claims-based methods for estimating the risk of deep incisional and organ/space infections following CABG surgery, hip arthroplasty, and knee arthroplasty, and use these methods to determine year-to-year predictive utility of hospital rankings, 3) assess the generalizability of hospital SSI rankings using Medicare claims compared to hospital rankings derived from all-payer claims databases, and from rankings based on state mandated reporting to NHSN, and 4) evaluate statistical approaches to evaluate the performance of hospitals with low procedure volumes.

描述（由申请人提供）：医疗保健研究和质量局（AHRQ）、疾病控制和预防中心（CDC）和医疗保险和医疗补助服务中心（CMS）都表示有兴趣开发有效的质量措施，用于医院间医疗保健相关感染的比较，包括手术部位感染（ssi）。AHRQ的基于索赔的质量指标已应用于通过医疗保健成本和利用项目收集的管理数据。医疗保险已经开始实施一项基于价值的采购计划，该计划将包括医院使用疾病预防控制中心的国家医疗安全网络（NHSN）报告的深切口和器官/空间ssi。报告SSI风险较高的医院将获得较低的报销。因此，无论是在大型外科中心还是在手术量较少的医院，都需要针对高风险手术改进监测和有效的质量措施。与医院感染控制项目的传统SSI监测相比，索赔数据已被证明提供了更标准化和全面的捕获。我们建议通过针对各州要求公开报告的程序和CMS提出的基于价值的采购程序，扩大我们之前在使用索赔数据进行SSI监控方面的工作。我们将1)扩展我们之前成功的基于索赔的冠状动脉旁路移植术（CABG）手术和髋关节置换术后的监测，以识别膝关节置换术（另一种高容量和高成本的手术）后SSI风险异常高的医院，2)识别和验证基于索赔的方法，用于估计CABG手术、髋关节置换术和膝关节置换术后深切口和器官/间隙感染的风险。并使用这些方法来确定医院排名的年度预测效用，3)使用医疗保险索赔来评估医院SSI排名的通用性，将医院排名与来自所有付款人索赔数据库的医院排名进行比较，以及基于国家强制报告给NHSN的排名，以及4)评估统计方法来评估低业务量医院的表现。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Surgical Site Infections: Volume-Outcome Relationship and Year-to-Year Stability of Performance Rankings.

DOI：
10.1097/mlr.0000000000000620
发表时间：
2017-01
期刊：
Medical care
影响因子：
3
作者：
Calderwood MS;Kleinman K;Huang SS;Murphy MV;Yokoe DS;Platt R
通讯作者：
Platt R

Variable Case Detection and Many Unreported Cases of Surgical-Site Infection Following Colon Surgery and Abdominal Hysterectomy in a Statewide Validation.

全州范围内验证中结肠手术和腹部子宫切除术后手术部位感染的可变病例检测和许多未报告的病例。

DOI：
10.1017/ice.2017.134
发表时间：
2017
期刊：
Infection control and hospital epidemiology
影响因子：
4.5
作者：
Calderwood,MichaelS;Huang,SusanS;Keller,Vicki;Bruce,ChristinaB;Kazerouni,NNeely;Janssen,Lynn
通讯作者：
Janssen,Lynn

Improving public reporting and data validation for complex surgical site infections after coronary artery bypass graft surgery and hip arthroplasty.

DOI：
10.1093/ofid/ofu106
发表时间：
2014-12
期刊：
Open forum infectious diseases
影响因子：
4.2
作者：
Calderwood MS;Kleinman K;Murphy MV;Platt R;Huang SS
通讯作者：
Huang SS

Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.

利用声称可以改善子宫切除术和结直肠手术后手术部位感染的检测。

DOI：
10.1086/673975
发表时间：
2013
期刊：
Infection control and hospital epidemiology
影响因子：
4.5
作者：
Letourneau,AlyssaR;Calderwood,MichaelS;Huang,SusanS;Bratzler,DaleW;Ma,Allen;Yokoe,DeborahS
通讯作者：
Yokoe,DeborahS