Kyle H. Sheetz is a general surgery resident in the Department of Surgery, University of Michigan Medical School, in Ann Arbor.
Justin B. Dimick is the Frederick A. Coller Professor of Surgery and chair of the Department of Surgery, University of Michigan Medical School.
Health Aff (Millwood). 2019 Nov;38(11):1858-1865. doi: 10.1377/hlthaff.2018.05504.
In 2013 the Centers for Medicare and Medicaid Services announced that it would begin levying penalties against hospitals with the highest rates of hospital-acquired conditions through the Hospital-Acquired Condition Reduction Program. Whether the program has been successful in improving patient safety has not been independently evaluated. We used clinical registry data on rates of hospital-acquired conditions in 2010-18 from a large surgical collaborative in Michigan to estimate the impact of the policy. While rates of all such conditions declined from 133.4 per 1,000 discharges in the pre-program period to 122.2 in the post-program period, greater improvements were observed for nontargeted measures. We conclude that the program did not improve patient safety in Michigan beyond existing trends. These findings raise questions about whether the program will lead to improvements in patient safety as intended.
2013 年,医疗保险和医疗补助服务中心宣布,将通过医院获得条件减少计划对获得条件发生率最高的医院进行处罚。该计划在提高患者安全性方面是否取得成功尚未得到独立评估。我们使用密歇根州一个大型外科合作机构 2010-18 年的临床登记数据来估计该政策的影响。虽然所有这些条件的发生率从计划前的每千次出院 133.4 例下降到计划后的 122.2 例,但针对非目标措施的改善更为显著。我们的结论是,该计划并没有改善密歇根州的患者安全性,也没有超越现有趋势。这些发现引发了关于该计划是否会按预期改善患者安全性的问题。