TY - JOUR
T1 - State-Mandated Hospital Infection Reporting Is Not Associated with Decreased Pediatric Health Care-Associated Infections
AU - Rinke, Michael L.
AU - Bundy, David G.
AU - Abdullah, Fizan
AU - Colantuoni, Elizabeth
AU - Zhang, Yiyi
AU - Miller, Marlene R.
N1 - Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/9/7
Y1 - 2015/9/7
N2 - Objectives State governments increasingly mandate public reporting of central line-associated blood stream infections (CLABSIs). This study tests if hospitals located in states with state-mandated, facility-identified, pediatric-specific public CLABSI reporting have lower rates of CLABSIs as defined by the Agency for Healthcare Research and Quality's Pediatric Quality Indicator 12 (PDI12). Methods Utilizing the Kids' Inpatient Databases from 2000 to 2009, we compared changes in PDI12 rates across three groups of states: states with public CLABSI reporting begun by 2006, states with public reporting begun by 2009 and never-reporting states. In the baseline period (2000-2003), no states mandated public CLABSI reporting. A multivariable, hospital-level random intercept, logistic regression was performed comparing changes in PDI12 rates in states with public reporting to changes in PDI12 rates in never-reporting states. Results 4,705,857 discharge records were eligible for PDI12. PDI12 rates significantly decreased in all reporting groups, comparing baseline to the post-public reporting period (2009): Never Reporters 88% decrease (95% CI, 86%-89%), Reporting Begun by 2006 90% decrease (95% CI, 83%-94%), and Reporting Begun by 2009 74% decrease (95% CI, 72%-76%). The Never Reporting Group had comparable decreases in PDI12 rates to the Reporting Begun by 2006 group (P = 0.4) and significantly larger decreases in PDI12 rates compared to the Reporting Begun by 2009 group (P < 0.001), despite having no states with public reporting. Conclusions Public CLABSI reporting alone appears to be insufficient to affect administrative data-based measures of pediatric CLABSI rates or children may be inadequately targeted in current public reporting efforts.
AB - Objectives State governments increasingly mandate public reporting of central line-associated blood stream infections (CLABSIs). This study tests if hospitals located in states with state-mandated, facility-identified, pediatric-specific public CLABSI reporting have lower rates of CLABSIs as defined by the Agency for Healthcare Research and Quality's Pediatric Quality Indicator 12 (PDI12). Methods Utilizing the Kids' Inpatient Databases from 2000 to 2009, we compared changes in PDI12 rates across three groups of states: states with public CLABSI reporting begun by 2006, states with public reporting begun by 2009 and never-reporting states. In the baseline period (2000-2003), no states mandated public CLABSI reporting. A multivariable, hospital-level random intercept, logistic regression was performed comparing changes in PDI12 rates in states with public reporting to changes in PDI12 rates in never-reporting states. Results 4,705,857 discharge records were eligible for PDI12. PDI12 rates significantly decreased in all reporting groups, comparing baseline to the post-public reporting period (2009): Never Reporters 88% decrease (95% CI, 86%-89%), Reporting Begun by 2006 90% decrease (95% CI, 83%-94%), and Reporting Begun by 2009 74% decrease (95% CI, 72%-76%). The Never Reporting Group had comparable decreases in PDI12 rates to the Reporting Begun by 2006 group (P = 0.4) and significantly larger decreases in PDI12 rates compared to the Reporting Begun by 2009 group (P < 0.001), despite having no states with public reporting. Conclusions Public CLABSI reporting alone appears to be insufficient to affect administrative data-based measures of pediatric CLABSI rates or children may be inadequately targeted in current public reporting efforts.
KW - Pediatric
KW - central line-associated blood stream infection
KW - health care-associated infection
KW - kids' inpatient database
KW - public reporting
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U2 - 10.1097/PTS.0000000000000056
DO - 10.1097/PTS.0000000000000056
M3 - Review article
C2 - 24681422
AN - SCOPUS:84940960702
SN - 1549-8417
VL - 11
SP - 123
EP - 134
JO - Journal of patient safety
JF - Journal of patient safety
IS - 3
ER -