CAUTI reporting guidelines inflate hospitals' performance, study suggests

Changes in national reporting guidelines for catheter-associated urinary tract infections have significantly improved hospitals' infection ratios since 2015, which offers an inaccurate depiction of quality performance unrelated to patient outcomes, according to a study published Sept. 16 in Infection Control and Hospital Epidemiology

CAUTIs are tracked as part of federal value-based incentive programs implemented in 2015. Researchers from Boston University School of Medicine analyzed data reported by 592 hospitals to the CDC, finding that CAUTI rates decreased by 42 percent when the incentive programs were implemented.

"While this may seem like an effect of the programs, the large decline [in] CAUTI rates was actually due to a concurrent change in which infections 'count' as CAUTI," co-author Heather Hsu, MD, assistant professor of pediatrics at Boston University, told Medical Express.

After the guideline revision, more hospitals had favorable standardized infection ratios. "The case of CAUTI is an illustration of how measurement changes can not only impact evaluations of hospital performance but also potentially lead to inappropriate assessments of financial rewards or penalties that do not reflect meaningful differences in patient safety or hospital performance," Dr. Hsu told Medical Express.

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