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Trends in Hospital Care-Associated Conditions

By March 23, 2017Commentary

When you go to a doctor’s office, hospital or other health care setting, the last thing you expect is to have something happens that makes you sicker, but it does happen a fair amount.  Contracting infections, falls, being given the wrong drug or the wrong dose, etc. are more common than they should be, and regulators and payers, including CMS, have adopted programs to either penalize providers when this happens or to help them improve quality by avoiding these health care-associated conditions.  A recent Agency for Healthcare Research & Quality report focuses on the trend in hospital-acquired conditions (“HACs”).   (AHRQ Report)   From 2010 to 2015, there has been a 21% reduction in the number of HACs.  The estimated rate for 2015 was 115 HACs per 1000 hospital discharges.  According to AHRQ, over the five year period from 2010 to 2015, this reduction meant 3.1 million fewer HACs, resulting in 125,000 fewer deaths and $28 billion less in spending.

Adverse drug events represent 34% of all hospital-acquired conditions, and reductions in these were responsible for 42% of the overall HAC reduction.  Pressure ulcers account for 27% of HACs and 23% of the reduction, and urinary catheter infections are 8% of HACs and account for 15% of reductions.  Other HAC categories represent smaller proportions, but every category has seen reductions in occurrence.  Many of these are quite serious in their impacts on patient health, so the reductions are meaningful in terms of overall quality.  The largest categories have obviously seen the most attention and the change in the last five years reflects this.  The reductions to date are good, but obviously further improvement is greatly needed.  In fact, you would like to think that we could make contracting additional health conditions while receiving health care a very rare occurrence.

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