BACKGROUND: In 2007, the Centers for Medicare & Medicaid Services (CMS) announced its intention to no longer reimburse hospitals for costs associated with hospital-acquired pressure ulcers (HAPUs) and a list of other hospital-acquired conditions (HACs), which was followed by enactment of the nonpayment policy in October 2008. This study was conducted to define changes in HAPU incidence and variance since 2008. METHODS: In a retrospective observational study, HAPU cases were identified at 210 University HealthSystem Consortium (UHC) academic medical centers in the United States. HAPU incidence rates were calculated as a ratio of HAPU cases to the total number of UHC inpatients between the first quarter of 2008 and the second quarter of 2012. HAPU cases were defined by multiple criteria: not present on admission (POA); coded for stage III or IV pressure ulcers; and a length of stay greater than four days. RESULTS: Among the UHC hospitals between 2008 and June 2012, 10,386 HAPU cases were identified among 4.08 million inpatients. The HAPU incidence rate decreased significantly from 11.8 cases per 1,000 inpatients in 2008 to 0.8 cases per 1,000 in 2012 (p < .001; 95% confidence interval: 8.39-8.56). Among HAPU cases were trends of more elderly patients, greater case-mix index, and more surgical cases. The analysis of covariance model identified CMS non-payment policy as a significant covariate of changing trends in HAPU incidence rates. CONCLUSIONS: HAPU incidence rates decreased significantly among 210 UHC AMCs after the enactment of the CMS nonpayment policy. The hospitals appeared to be reacting efficiently to economic policy incentives by improving prevention efforts.
BACKGROUND: In 2007, the Centers for Medicare & Medicaid Services (CMS) announced its intention to no longer reimburse hospitals for costs associated with hospital-acquired pressure ulcers (HAPUs) and a list of other hospital-acquired conditions (HACs), which was followed by enactment of the nonpayment policy in October 2008. This study was conducted to define changes in HAPU incidence and variance since 2008. METHODS: In a retrospective observational study, HAPU cases were identified at 210 University HealthSystem Consortium (UHC) academic medical centers in the United States. HAPU incidence rates were calculated as a ratio of HAPU cases to the total number of UHC inpatients between the first quarter of 2008 and the second quarter of 2012. HAPU cases were defined by multiple criteria: not present on admission (POA); coded for stage III or IV pressure ulcers; and a length of stay greater than four days. RESULTS: Among the UHC hospitals between 2008 and June 2012, 10,386 HAPU cases were identified among 4.08 million inpatients. The HAPU incidence rate decreased significantly from 11.8 cases per 1,000 inpatients in 2008 to 0.8 cases per 1,000 in 2012 (p < .001; 95% confidence interval: 8.39-8.56). Among HAPU cases were trends of more elderly patients, greater case-mix index, and more surgical cases. The analysis of covariance model identified CMS non-payment policy as a significant covariate of changing trends in HAPU incidence rates. CONCLUSIONS: HAPU incidence rates decreased significantly among 210 UHC AMCs after the enactment of the CMS nonpayment policy. The hospitals appeared to be reacting efficiently to economic policy incentives by improving prevention efforts.
Authors: Danielle M Minteer; Patsy Simon; Donald P Taylor; Wenyan Jia; Yuecheng Li; Mingui Sun; J Peter Rubin Journal: Adv Wound Care (New Rochelle) Date: 2019-12-06 Impact factor: 4.730
Authors: Lee Squitieri; David A Ganz; Carol M Mangione; Jack Needleman; Patrick S Romano; Debra Saliba; Clifford Y Ko; Daniel A Waxman Journal: BMJ Qual Saf Date: 2017-07-28 Impact factor: 7.035
Authors: Victoria Team; Ayoub Bouguettaya; Catelyn Richards; Louise Turnour; Angela Jones; Helena Teede; Carolina D Weller Journal: Int Wound J Date: 2019-12-18 Impact factor: 3.315
Authors: Charalampos Siotos; Andrew M Bonett; George Damoulakis; Adan Z Becerra; George Kokosis; Keith Hood; Amir H Dorafshar; Deana S Shenaq Journal: Eplasty Date: 2022-06-13
Authors: June Rondinelli; Stephen Zuniga; Patricia Kipnis; Lina Najib Kawar; Vincent Liu; Gabriel J Escobar Journal: Nurs Res Date: 2018 Jan/Feb Impact factor: 2.381
Authors: William V Padula; Robert D Gibbons; Peter J Pronovost; Donald Hedeker; Manish K Mishra; Mary Beth F Makic; John Fp Bridges; Heidi L Wald; Robert J Valuck; Adam J Ginensky; Anthony Ursitti; Laura Ruth Venable; Ziv Epstein; David O Meltzer Journal: J Am Med Inform Assoc Date: 2017-04-01 Impact factor: 4.497