@article{768,
  keywords = {Hospitals, Medicare, Quality Of Care},
  author = {Shawna Smith and Ashley Snyder and Laurence F. McMahon and Laura Petersen and Jennifer Meddings},
  title = {Success In Hospital-Acquired Pressure Ulcer Prevention: A Tale In Two Data Sets.},
  abstract = {<p>Chart-based surveillance reviews indicate that the incidence of hospital-acquired pressure ulcers (HAPUs) declined 23 percent during 2010-14, equating to an estimated savings of $1 billion during that period. Yet it remains unclear whether the administrative data used to implement three Medicare value-based purchasing programs that target HAPUs indicate similar improvements, and how success varied by HAPU severity. These programs measure and penalize only for more severe ulcers (stage 3 or 4 or unstageable), which are much more costly than less severe cases (stage 1 or 2). We assessed HAPU incidence, severity, and trends using administrative data for 2009-14 from three states. The HAPU incidence we found was approximately one-twentieth of that found in chart-based surveillance review data. HAPU incidence in administrative data declined, but 96 percent of the change was due to a decline in the incidence of less severe HAPUs. Transitioning from administrative data to chart-based surveillance review to measure HAPUs (mirroring changes that have already been made in reporting hospital-acquired infections) and accounting for HAPU severity could improve the validity of HAPU measures for assessing the clinical and financial impact of value-based purchasing interventions.</p>},
  year = {2018},
  journal = {Health Aff (Millwood)},
  volume = {37},
  pages = {1787-1796},
  month = {12/2018},
  issn = {1544-5208},
  doi = {10.1377/hlthaff.2018.0712},
  language = {eng},
}