iLoveBenefits: Industry News Blog

AHRQ Report: Hospital-acquired Conditions Continue to Decline, Saving Lives and Costs

 

 

The Department of Health and Human Services released an AHRQ report today showing that an estimated 87,000 fewer patients died in hospitals and nearly $20 billion in health care costs were saved as a result of reductions in hospital-acquired conditions (HACs) from 2010 to 2014. The report indicates that HACs were reduced by 17 percent in 2014, contributing to an overall reduction of 2.1 million HACs since 2010. To develop the report Saving Lives & Saving Money: Hospital-Acquired Conditions Update, AHRQ analyzed the incidence of avoidable HACs compared to 2010 rates, using as a baseline estimates of deaths and excess health care costs that were developed when the Partnership for Patients was launched.  AHRQ’s analysis included a number of HACs including adverse drug events, catheter-associated urinary tract infections, central line associated bloodstream infections, pressure ulcers, and surgical site infections, among others. AHRQ has produced a variety of tools and resources to help hospitals and other providers prevent hospital-acquired conditions, such as reducing infections, pressure ulcers, and falls. Recently the Toolkit for Reducing CAUTI in Hospitals was released, which is based on the experiences of more than 1,200 hospitals nationwide that participated in an AHRQ-funded project to apply the Comprehensive Unit-based Safety Program to reducing catheter associated urinary tract infections (CAUTI). This new report updates data released in December 2014.

Quality of Care and Patient Safety Are Improving, Particularly for Hospital Care, Though Additional Work Remains

New AHRQ Report:

The overall quality of health care and patient safety are improving, particularly for hospital care and for measures that are being publicly reported by the Centers for Medicare & Medicaid Services, according to the newly released 2014 National Healthcare Quality and Disparities Report from the Agency for Healthcare Research and Quality.

Among the highlights in this year’s report:

  • Hospital care was safer in 2013 than in 2010, with 17 percent fewer harms to patients and an estimated 1.3 million fewer hospital-acquired conditions, 50,000 fewer deaths, and $12 billion in cost savings over three years (2011, 2012, 2013). However, quality is still far from optimal, with millions of patients harmed by the care they receive, and only 70 percent of recommended care being delivered across a broad array of quality measures.
  • A few disparities among racial groups for services such as childhood vaccinations have been reduced to zero; however, much additional work remains to address a broad range of other disparities affecting quality of care.

This year’s report has been consolidated and tracks performance measures that align with the National Quality Strategy. Chartbooks on specific topics such as patient safety and care coordination will be issued in coming months to provide more detailed information and easy-to-understand slides that can be downloaded for presentations.

The report provides a snapshot of health care quality and disparities based on trend analyses from 2000-2002 to 2011-2012 (except for select measures of access to care tracked through the first half of 2014, and for adverse events in hospitals tracked through 2013). Because most data precede implementation of a majority of the health insurance expansions included in the Affordable Care Act, the report serves as a baseline for measuring progress in future years.

Select here to download your complimentary copy of the report. To order a print copy, email ahrqpubs@ahrq.hhs.gov or call 1-800-358-9295.

Infections: When We Do What We Know How To Do

According to a recent CDC report on healthcare-associated infections, on a national level there has been:

  • central line-associated bloodstream infections (CLABSI) decreased 46% between 2008 and 2013
  • surgical site infections (SSI) related to 10 select procedures decreased 19% between 2008 and 2013
  • catheter-associated urinary tract infections (CAUTI) increased 6% since 2009
  • MRSA bloodstream infections decreased 8% between 2011 and 2013

Source: “Progress Being Made in Infection Control in U.S. Hospitals; Continued Improvements Needed,” Centers for Disease Control and Prevention Press Release, January 14, 2015, http://www.cdc.gov/media/releases/2015/p0114-MRSA-hospitals-report.html

Right Measures; Right Incentives; Right Results

A report released on Tuesday by HHS shows “an estimated 50,000 fewer patients died in hospitals and approximately $12 billion in health care costs were saved as a result of a reduction in hospital-acquired conditions from 2010 to 2013.  This progress toward a safer health care system occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events. The efforts were due in part to provisions of the Affordable Care Act such as Medicare payment incentives to improve the quality of care and the HHS Partnership for Patients initiative.  Preliminary estimates show that in total, hospital patients experienced 1.3 million fewer hospital-acquired conditions from 2010 to 2013.  This translates to a 17 percent decline in hospital-acquired conditions over the three-year period.”

Hospital Acquired Conditions – Concerted, Coordinated Efforts Across Health Care Stakeholders Make a Difference

HHS: Hospital-acquired conditions, inpatient mortality are down The incidence of hospital-acquired conditions fell 17% from 2010 to 2013, while inpatient deaths dropped by close to 35,000 in 2013, according to an HHS report. The reduction was attributed in part to health IT tools designed to improve quality. Healthcare Informatics online

Don’t only focus on what’s wrong with the measure

. . . Focus on what’s rght with the goal.

New HHS preliminary data show an overall 9 percent decrease in hospital acquired conditions nationally during 2011 and 2012. National reductions in adverse drug events, falls, infections and other forms of hospital-induced harm are estimated to have prevented nearly 15,000 hospital deaths, avoided 560,000 patient injuries and saved approximately $4 billion in health spending during that period.

The Affordable Care Act is also helping reduce hospital readmissions. After holding constant at 19 percent from 2007 to 2011 and decreasing to 18.5 percent in 2012, the Medicare all-cause 30-day readmission rate further decreased to approximately 17.5 percent in 2013. This represents an 8 percent reduction in the rate and an estimated 150,000 fewer hospital readmissions among Medicare beneficiaries between January 2012 and December 2013.

These major strides in patient safety are a result of public-private partnerships and active engagement by patients and families and include efforts from the federal Partnership for Patients initiative and Hospital Engagement Networks, Quality Improvement Organizations, the Agency for Healthcare Research and Quality, the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and many others.

 

Select to access the HHS news release and the AHRQ methods report.

Hospital Acquired Infections Continue

The CDC released new data that finds, despite progress, hospital-acquired infections (HAIs) continue to claim tens of thousands of lives annually in the United States.  “Based on a large sample of U.S. acute care hospitals, the survey found that on any given day, about 1 in 25 hospital patients has at least one healthcare-associated infection.  There were an estimated 722,000 HAIs in U.S acute care hospitals in 2011.  About 75,000 hospital patients with HAIs died during their hospitalizations.  More than half of all HAIs occurred outside of the intensive care unit.”

Surgical Site Infection Rates in the Outpatient Setting

Serious Surgical Site Infection Rates in Outpatient Settings

In a study published in the Journal of the American Medical Association,  researchers used AHRQ’s Healthcare Cost and Utilization Project databases to analyze serious surgical site infections (SSIs) rates following surgery in hospital-owned ambulatory (outpatient) settings in eight states. SSIs are among the most common type of healthcare-associated infection (HAI). The authors found that 877 patients in the eight states, or a rate of just over 3 (3.09) of every 1,000 patients, who had ambulatory surgery were treated within 14 days for a SSI that required hospitalization. At 30 days, the rate increased to nearly 5 (4.84) of every 1,000 patients. These data did not include procedures performed in physicians’ offices or freestanding facilities not owned by hospitals.

Source: Agency for Healthcare Research and Quality

The natural follow on question is how do outpatient SSI rates compare to inpatient rates??

Never go to a hosptial without a ‘personal bodyguard’

Over 1.7 million
Americans are diagnosed with healthcare-associated infections annually, killing
99,000 patients and costing U.S. hospitals between $28.4 to $45 billion each
year, according to a recent report.

Source:
“Healthcare-Associated Infections Are a Growing Threat to Seniors,”
Alliance for Aging Research News Release, July 22, 2013, http://www.agingresearch.org/content/article/detail/33442

Check your list twice to see who is . . .

In a nation-wide, federally funded project using an evidence-based tool kit that incorporates standardized checklists, the overall infection rate among participating hospitals fell 40% in 4 years (from 1.903 infections for every 1,000 days the patients had a central line inserted to a rate of 1.137 infections per 1,000 days).

Source: “AHRQ Patient Safety Project Reduces Bloodstream Infections by 40 Percent ,” Agency for Healthcare Research and Quality Press Release, September 10, 2012, http://www.ahrq.gov/news/press/pr2012/pspclabsipr.htm

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