Kenneth Obi1, Alice Hinton2, Lindsay Sobotka3, Edward Levine1, Darwin Conwell1, Cheng Zhang4. 1. Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave, 2nd Floor, Columbus, OH, 43210, USA. 2. Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA. 3. Department of Medicine, The Ohio State University, Wexner Medical Center, Columbus, OH, USA. 4. Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave, 2nd Floor, Columbus, OH, 43210, USA. cheng.zhang@osumc.edu.
Abstract
BACKGROUND: Crohn's disease (CD) is a chronically relapsing condition that frequently requires hospitalization. In 2008, the Centers for Medicare and Medicaid Services selected ten conditions that were deemed healthcare-acquired conditions (HACs). Costs related to HACs are not reimbursed as they are considered to be preventable. AIM: To determine the prevalence and impact of HACs on hospital outcomes of hospitalized CD patients. METHODS: This was a cross-sectional study using data from the Nationwide Inpatient Sample between 2007 and 2011 with an extended time frame between 2002 and 2013 to specifically evaluate the prevalence of HACs. CD-related hospitalizations and HACs were identified using International Classification of Diseases, Ninth revision, Clinical modification codes. The trend of HACs between 2002 and 2013 was assessed using a Cochran-Armitage test. Primary outcomes, including hospital mortality, length of stay, and hospital charges, were analyzed using univariate and multivariate analyses. RESULTS: The prevalence of HACs initially increased between 2002 and 2008, remained stable between 2008 and 2011, than significantly decreased from 2011 to 2013. CD patients with HACs had higher hospital mortality, prolonged LOS, and higher hospital charges compared to patients without HACs. CONCLUSIONS: The prevalence of HACs among hospitalized CD patients initially increased from 2002 to 2008; however, rates began to decrease between 2011 and 2013. In addition, HACs were associated with worse healthcare outcomes in hospitalized CD patients.
BACKGROUND:Crohn's disease (CD) is a chronically relapsing condition that frequently requires hospitalization. In 2008, the Centers for Medicare and Medicaid Services selected ten conditions that were deemed healthcare-acquired conditions (HACs). Costs related to HACs are not reimbursed as they are considered to be preventable. AIM: To determine the prevalence and impact of HACs on hospital outcomes of hospitalized CDpatients. METHODS: This was a cross-sectional study using data from the Nationwide Inpatient Sample between 2007 and 2011 with an extended time frame between 2002 and 2013 to specifically evaluate the prevalence of HACs. CD-related hospitalizations and HACs were identified using International Classification of Diseases, Ninth revision, Clinical modification codes. The trend of HACs between 2002 and 2013 was assessed using a Cochran-Armitage test. Primary outcomes, including hospital mortality, length of stay, and hospital charges, were analyzed using univariate and multivariate analyses. RESULTS: The prevalence of HACs initially increased between 2002 and 2008, remained stable between 2008 and 2011, than significantly decreased from 2011 to 2013. CDpatients with HACs had higher hospital mortality, prolonged LOS, and higher hospital charges compared to patients without HACs. CONCLUSIONS: The prevalence of HACs among hospitalized CDpatients initially increased from 2002 to 2008; however, rates began to decrease between 2011 and 2013. In addition, HACs were associated with worse healthcare outcomes in hospitalized CDpatients.
Authors: Grace M Lee; Ken Kleinman; Stephen B Soumerai; Alison Tse; David Cole; Scott K Fridkin; Teresa Horan; Richard Platt; Charlene Gay; William Kassler; Donald A Goldmann; John Jernigan; Ashish K Jha Journal: N Engl J Med Date: 2012-10-11 Impact factor: 91.245