Impact of hospital-acquired pneumonia on the Medicare program.

Infect Control Hosp Epidemiol

CapView Strategies, Washington, DC.

Published: March 2024

AI Article Synopsis

  • - Hospital-acquired pneumonia (HAP) is a preventable infection in hospitals that significantly impacts patient safety and care quality, particularly among Medicare beneficiaries.
  • - A study comparing 2,457 Medicare patients with HAP to matched controls found that HAP patients were 2.8 times more likely to die within 90 days and had longer hospital stays and higher costs.
  • - The findings highlight the need for focused prevention strategies for HAP to enhance patient safety and reduce healthcare costs in the Medicare system.

Article Abstract

Objective: Patient safety organizations and researchers describe hospital-acquired pneumonia (HAP) as a largely preventable hospital-acquired infection that affects patient safety and quality of care. We provide evidence regarding the consequences of HAP among 2019 Medicare beneficiaries.

Design: Retrospective case-control study.

Patients: Calendar year 2019 Medicare beneficiaries with HAP during an initial hospitalization, defined by (ICD-10-CM) coding on inpatient claims (n = 2,457). Beneficiaries with HAP were matched using diagnosis-related group (DRG) codes with beneficiaries who did not experience HAP (n = 2,457).

Methods: The 2019 calendar year Medicare 5% Standard Analytic Files (SAF), for inpatient, outpatient, physician, and all postacute hospital settings. The case group (HAP) and control group (non-HAP) were matched on disease severity, age, sex, and race and were compared for hospital length of stay, costs, and mortality during the initial hospitalization and across settings for 30, 60, and 90 days after discharge. The 2019 fiscal year MedPAR Claims data were used to determine Medicare costs.

Results: Medicare beneficiaries with HAP were 2.8 times more likely to die within 90 days compared with matched beneficiaries who did not develop HAP. Among those who survived, beneficiaries with HAP spent 6.6 more days in the hospital (69%) and cost the Medicare program an average of $14,487 (24%) more per episode of care across initial inpatient and postdischarge services.

Conclusions: The findings of higher mortality and cost among Medicare beneficiaries who develop HAP suggest that HAP prevention should be prioritized as a patient safety and quality initiative for the Medicare program.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10933505PMC
http://dx.doi.org/10.1017/ice.2023.221DOI Listing

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