Worst Hospitals for Infections

[kbot]

Once again, CMS (Medicare) has released the list of hospitals where a penalty was imposed due to their inability to control hospital-acquired infections.

Something to keep in mind if you need to visit a hospital for elective cases.......

Hospital-Acquired Condition Reduction Program

In October 2014, CMS began reducing Medicare payments for subsection (d) hospitals that rank in the worst performing quartile of subsection (d) hospitals with respect to hospital-acquired conditions (HACs). For the FY 2016 HAC Reduction Program, the worst performing quartile is identified by calculating a Total HAC score based on the hospital’s performance on 4 quality measures; the Agency for Healthcare Research Quality (AHRQ) Patient Safety Indicator (PSI) 90 Composite, and the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Central-line Associated Bloodstream Infection (CLABSI), Catheter Associated Urinary Tract Infection (CAUTI), and Surgical Site Infection (SSI) (colon and hysterectomy) measures. Hospitals with a Total HAC score above the 75th percentile of the Total HAC Score distribution may be subject to payment reduction. In the FY 2016 HAC Reduction Program, hospitals with a Total HAC Score greater than 6.75 are subject to a payment reduction. The hospitals that are subject to a payment reduction can be found on CMS.gov- Opens in a new window.

https://www.medicare.gov/hospitalcompar ... ogram.html

The listing is by state........

[voguy]

What is the key column that you're interested in? Or shall I say, column and score which indicates a problem.

[kbot]

Scoring information is found here. In a nutshell, the higher the number 1 - 10, the worse the facility's score, and hence, the staff fared poorly against other facilities. I can tell you that we track just about al of these......

Scoring Methodology

Hospital-Acquired Condition (HAC) Reduction Program

The HAC Reduction Program incentivizes hospitals to reduce HACs as set forth in the Fiscal Year (FY) 2014 Inpatient Prospective Payment System/Long-Term Hospital Prospective Payment System (IPPS/LTCH PPS) Final Rule. The Centers for Medicare & Medicaid Services (CMS) identifies the worst-performing quartile of hospitals with respect to HACs by calculating a Total HAC Score. The Total HAC Score for FY 2016 is derived from measures in two domains:

Domain 1 – Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator (PSI) measure:
PSI 90 Composite

Domain 2 - Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) Healthcare-Associated Infection (HAI) measures:
Central Line-Associated Bloodstream Infection (CLABSI)
Catheter-Associated Urinary Tract Infection (CAUTI)
Surgical Site Infection (SSI) – colon and hysterectomy

There are three major steps to determining a hospital’s Total HAC Score:
1.Hospitals are classified based on their measure results. Specifically, each hospital is assigned a measure score between 1 and 10 for each of the measures in the two domains. This measure score reflects the hospital’s relative rank in 10 groups (or deciles) between the score of the best-performing hospital and the worst-performing hospital. Higher scores indicate worse performance.

Percentile

Points

1st - 10th

1

11th - 20th

2

21st – 30th

3

31st – 40th

4

41st – 50th

5

51st – 60th

6

61st – 70th

7

71st – 80th

8

81st – 90th

9

91st – 100th

10


2.Measure scores are used to determine the domain scores. For FY 2016, the Domain 1 score is determined by the points assigned for the PSI 90 Composite because that is the only measure in Domain 1. The measure scores of the three CDC measures determine the Domain 2 score. If a hospital has a measure score for CLABSI, CAUTI, and SSI, then the hospital’s Domain 2 score equals the average of the hospital’s CLABSI, CAUTI, and SSI measure scores. If a hospital has a score for only two of the three Domain 2 measures, then the hospital's Domain 2 score equals the average of the points assigned for the two measures with points. If a hospital has points for only one of the three Domain 2 measures, then the hospital’s Domain 2 score equals the number of points assigned to the measure with points. Finally, a hospital will not receive a domain score when it does not have measure scores for any of the measures within the given domain.

3.A hospital’s Total HAC Score is determined by the sum of the weighted Domain 1 and Domain 2 scores. For FY 2016, Domain 1 is weighted at 25 percent and Domain 2 is weighted at 75 percent of the Total HAC Score for hospitals that received a calculated Domain 1 score and Domain 2 score. If a hospital only has a score for one of the domains, then a weight of 100 percent will be applied to the domain for which the hospital has a score.

Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution may be subject to a payment reduction.

Refer to the FY 2016 HAC Reduction Program Hospital-Specific Report User Guide (PDF-1.2 MB) for more information on the scoring methodology used for the FY 2016 HAC Reduction Program.
https://www.qualitynet.org/dcs/ContentS ... 8774298601

[voguy]

I guess I'm missing something in your explanation. Take these two hospitals in the image below. Beaumont in Troy shows a AHRQ score of 1, while Detroit Receiving has a 10.

Hospital.jpg (207.48 KiB) Viewed 3842 times

What are we looking for? I would suspect that the hospital with the lower number is better?

[kbot]

Nope, exact opposite. Kinda like golf (which makes no sense to me, but is the only analog that I can use). The lower the number, the better.......

[voguy]

Nope, exact opposite. Kinda like golf (which makes no sense to me, but is the only analog that I can use). The lower the number, the better.......

OK. Lowest number. That helps understand how it works.

Being on the media side of things, we have a local hospital which brags about being the best, most services, and highest quality. They spend a ton on advertising. However, it seems like they have the highest cases of CDIF in the region, and I've heard numerous patients claim they have been warehoused without treatment, or have been given tests with no commonality to their reason for being there. In short, it seems like the least best care, while spending money on ads to tell the public they are the best. Same one which ODed me on antibiotics.

[kbot]

[quote="voguy] Same one which ODed me on antibiotics.[/quote]

Which is why they have high C-diff rates.......