Diekema Daniel J
Departments of Internal Medicine and Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
J Clin Microbiol. 2017 Apr;55(4):996-1001. doi: 10.1128/JCM.02544-16. Epub 2017 Jan 25.
Health care-associated infection (HAI) rates are subject to public reporting and are linked to hospital reimbursement from the Centers for Medicare and Medicaid Services (CMS). The increasing pressure to lower HAI rates comes at a time when advances in the clinical microbiology laboratory (CML) provide more-precise and -sensitive tests, altering HAI detection in ways that may increase reported HAI rates. I review how changing CML practices can impact HAI rates and how the financial implications of HAI metrics may produce pressure to change diagnostic testing practices. Finally, I provide suggestions for how to respond to this rapidly changing environment.
医疗保健相关感染（HAI）率需接受公开报告，并与医疗保险和医疗补助服务中心（CMS）给予医院的报销相关联。在临床微生物学实验室（CML）取得进展从而能够提供更精确、更灵敏的检测方法，以可能提高报告的HAI率的方式改变HAI检测之时，降低HAI率的压力也在不断增加。我回顾了CML实践的变化如何影响HAI率，以及HAI指标的财务影响如何可能产生改变诊断检测实践的压力。最后，我针对如何应对这一快速变化的环境提供了建议。
