Comparison of Administrative Data Versus Infection Control Data in Identifying Central Line–Associated Bloodstream Infections in Children’s Hospitals

[摘要] Objective: As of July 2012, the Centers for Medicare and Medicaid Services prohibited state Medicaid programs from paying for medical care related to certain provider-preventable conditions. The most prevalent provider-preventable condition in pediatrics is central line–associated bloodstream infections (CLABSIs), which cause significant morbidity and mortality. The objective of this study was to compare the uses of administrative data and infection control data in measuring CLABSIs.Methods: Retrospective chart reviews were performed in 3 children’s hospitals to compare CLABSIs identified according to administrative data diagnostic coding versus infections identified by hospital infection control departments. Clinical criteria from the Centers for Disease Control and Prevention and reported to the National Healthcare Safety Network were used.Results: A total of 166 CLABSIs were identified in 35 698 discharges in the 3 children’s hospitals in 2010. Using the Centers for Disease Control and Prevention criteria as the standard, administrative data had 34.78% sensitivity and 99.92% specificity. The positive predictive value was 63.16% whereas the negative predictive value was 99.75%.Conclusions: Administrative data and National Healthcare Safety Network criteria identify discordant numbers of CLABSIs.* Abbreviations: ACA : Patient Protection and Affordable Care Act AHRQ : Agency for Healthcare Research and Quality CDC : Centers for Disease Control and Prevention CLABSI : central line–associated bloodstream infections CMS : Centers for Medicare & Medicaid Services NHSN : National Healthcare Safety Network ICD-9-CM : International Classification of Diseases, Ninth Revision, Clinical Modification POA : present on admission PPC : provider-preventable conditions PSI : patient safety indicators

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob