Healthcare-associated infection differences within Hospital Referral Regions in Georgia

BACKGROUND: Healthcare-associated infections (HAI) are preventable health outcomes that occur during or because of a health-related intervention such as hospital stay, surgery, or device-associated interventions. HAI is the fifth leading cause of death in acute-care hospitals in the US. The Centers for Medicare & Medicaid Services (CMS) provides publicly available data including HAI for healthcare consumers to compare hospitals. Previous researchers have criticized the use of HAI data for hospital comparisons for consumers and reporting mandate placed on hospitals. Given the scarcity of data reported by hospitals, the objective of this study is to determine the effectiveness of HAI data as a proxy for quality in acute-care hospitals in Georgia.

METHODS: Secondary analysis was done using data from the Center for Disease Control and Prevention’s National Healthcare Safety Network (NHSN). Data from 1/1/2019 – 12/31/2019 was provided as Standard Infection Ratio (SIR) through Hospital Compare at CMS. SIRs for 6 HAIs were accessed across and within Hospital Referral Regions (HRR) in Georgia.

RESULTS: Out of 129 acute-care hospitals in Georgia, 51.94% reported SIRs for catheter-associated urinary tract infections (CAUTI), 45.74% for central line-associated bloodstream infections (CLABSI), 72.87% for Clostridium difficile (CDI), 42.64% for methicillin-resistant staphylococcus aureus (MRSA), 25.58% for surgical site infection (SSI) Abdomen, and 42.64% for SSI Colon. Clostridium difficile infection had the highest proportion (90.9%) of HRRs with at least 50% of its facilities reporting CDI data. CAUTI had the second highest proportion (45.5%).

CONCLUSION: There is not sufficient differentiation in HAI SIRs among acute-care hospitals for useful comparison of facilities by health care consumers except for CDI. Underreporting or lack of incidence may be the source of insufficiency.