June 22, 2018

Rate of hospital-acquired conditions fell by 8% from 2014 to 2016, data show

Daily Briefing

    The rate of hospital-acquired conditions (HACs) in the United States fell by 8% from 2014 to 2016, resulting in about 8,000 fewer deaths and saving about $2.9 billion in health care costs, according to preliminary data released by the federal government earlier this month.

    According to CMS, examples of HACs include:

    • Adverse drug events;
    • Catheter-associated urinary tract infections;
    • Central-line associated bloodstream infections;
    • Pressure injuries; and
    • Surgical site infections.

    Data details

    The data come from the Agency for Healthcare Research and Quality's (AHRQ) latest National Scorecard on Hospital-Acquired Conditions. The data are based on preliminary reports on 28 patient safety measures for patients discharged from hospitals in 2016. AHRQ noted that the final data for all patients discharged from hospitals in 2016, as well as data on seven of the 28 patient safety measures, are not yet available, meaning the estimates included in the scorecard could change.

    AHRQ also noted that the 2016 data are based on "a larger portion of hospital inpatients" than its 2014 data. AHRQ adjusted 2014 baselines to account for the change.

    Scorecard shows decline in HACs

    CMS in a release said the AHRQ data show that a total of 350,000 HACs were avoided between 2014 and 2016, with a total of 2.1 million HACs avoided between 2010 and 2014. CMS noted that the agency "has set a goal of reducing [HACs] by 20% from 2014 through 2019." According to the data, the rate of HACs fell 8% from 2014 through 2016.

    The data showed that the rate of HACs decreased across several different categories from 2014 to 2016. According to the data, the rate of:

    • Adverse drug events decreased by 15%;
    • Central-line associated bloodstream infections decreased by 31%;
    • Clostridium difficile infections decreased by 11%;
    • Falls decreased by 9%;
    • Obstetric adverse events decreased by 5%;
    • Ventilator-associated pneumonias decreased by 32%; and
    • Post-operative venous thromboembolisms decreased by 21%.

    The data also showed that the rate of some HACs increased from 2014 to 2016. According to the data, the rate of:

    • Catheter-associated urinary tract infections increased by 4%; and
    • Pressure ulcers increased by 10%.

    The data showed that the rate of surgical site infections remained unchanged from 2014 to 2016.

    CMS credited "national efforts to reduce [HACs]" for helping to decrease HAC rates. For instance, the agency cited its Hospital Improvement Innovation Networks initiative, through which CMS and other federal agencies, as well as private and patient advocacy groups, provide "intensive, focused quality improvement assistance to more than 4,000 of the nation's 5,000 hospitals by spreading best practices in harm reduction."

    Comments

    CMS Administrator Seema Verma said the data highlight "a tremendous accomplishment by America's hospitals in delivering high-quality, affordable health care." She continued, "CMS is committed to moving the health care system to one that improves quality and fosters innovation while reducing administrative burden and lowering costs. This work could not be accomplished without the concerted effort of our many hospital, patient, provider, private, and federal partners—all working together to ensure the best possible care by protecting patients from harm and making care safer."

    AHRQ Director Gopal Khanna said the data "identify important goals for ongoing efforts to protect patients." She added, "These data not only help us track how we're doing, but they help us set the target for where we need to go" (Leonard, Washington Examiner, 6/5; CMS release, 6/5; AHRQ scorecard, June 2018).

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