Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Med Care. 2014 Jun;52(6):469-78. doi: 10.1097/MLR.0000000000000106.
Most catheter-associated urinary tract infections (CAUTIs) are considered preventable and thus a potential target for health care quality improvement and cost savings.
We sought to estimate excess Medicare reimbursement, length of stay, and inpatient death associated with CAUTI among hospitalized beneficiaries.
Using a retrospective cohort design with linked Medicare inpatient claims and National Healthcare Safety Network data from 2009, we compared Medicare reimbursement between Medicare beneficiaries with and without CAUTIs.
Fee-for-service Medicare beneficiaries aged 65 years or older with continuous coverage of parts A (hospital insurance) and B (supplementary medical insurance).
We found that beneficiaries with CAUTI had higher median Medicare reimbursement [intensive care unit (ICU): $8548, non-ICU: $1479) and length of stay (ICU: 8.1 d, non-ICU: 3.6 d) compared with those without CAUTI controlling for potential confounding factors. Odds of inpatient death were higher among beneficiaries with versus without CAUTI only among those with an ICU stay (ICU: odds ratio 1.37).
Beneficiaries with CAUTI had increased Medicare reimbursement and length of stay compared with those without CAUTI after adjusting for potential confounders.
大多数与导管相关的尿路感染（CAUTI）被认为是可以预防的，因此是医疗保健质量改进和节省成本的潜在目标。
我们旨在估计与住院患者的 CAUTI 相关的医疗保险过度报销、住院时间和住院死亡。
使用回顾性队列设计，结合 2009 年医疗保险住院索赔和国家医疗保健安全网络数据，我们比较了有和没有 CAUTI 的医疗保险受益人的医疗保险报销情况。
年龄在 65 岁或以上、有 A 部分（医院保险）和 B 部分（补充医疗保险）连续保险的医疗保险按服务收费受益人的。
我们发现，在控制了潜在混杂因素后，与没有 CAUTI 的患者相比，有 CAUTI 的患者的医疗保险报销中位数更高[重症监护病房（ICU）：8548 美元，非 ICU：1479 美元]和住院时间（ICU：8.1 天，非 ICU：3.6 天）。只有在 ICU 住院的患者中，与没有 CAUTI 的患者相比，CAUTI 患者的住院期间死亡的可能性更高（ICU：比值比 1.37）。
在调整了潜在混杂因素后，与没有 CAUTI 的患者相比，有 CAUTI 的患者的医疗保险报销和住院时间增加。
