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Medicare Begins Posting Data Comparing Hospitals on Efforts to Prevent Surgical Infections

SEPTEMBER 2, 2005 -- Centers for Medicare and Medicaid Services (CMS) officials said Friday they've loaded more data onto their Hospital Compare Web site, including information that for the first time allows users to compare efforts by local facilities to prevent surgical infections.

The data added to the site ( also shows how individual facilities stack up against statewide and national averages on surgical infection prevention.

One measure indicates the percentage of surgery patients who receive preventative antibiotics one hour before incision, and the other the percentage of patients whose preventative antibiotics are stopped within 24 hours after surgery. Getting antibiotics an hour before surgery helps prevent infection, but taking them more than 24 hours later can increase risks of side effects and antibiotic resistance.

Data collection on the measures is still in its beginning stages. For example, users in the Washington, D.C. area will find that the site does not include data on the surgical infection measures for Johns Hopkins Hospital in nearby Baltimore or Holy Cross Hospital in suburban Maryland.

For Maryland facilities that have begun reporting the data, the statewide average for the percentage of surgical patients receiving preventative antibiotics an hour before incision is 76 percent. The national average is 69 percent. As of now, information on surgical prevention is available on the site for some 600 facilities nationwide.

The new measures are the first of a larger set of patient safety measures that hospitals will collect as part of the public-private voluntary Surgical Care Improvement Project. The initiative aims to reduce post-operative complications at U.S. hospitals by 25 percent.

Hospital Compare, which went live in April, now includes data on 20 quality measures. Reporting on some of the measures remains light, but the volume of quality data on the site is growing overall. More than 90 percent of the participating 4,048 hospitals in the United States report data on 10 "starter kit" measures; doing so entitles them to higher Medicare reimbursement.

Reporting is voluntary, but increasingly is tied to reimbursement. "Pay-for-performance" bills (S 1356, HR 2791, HR 855) pending in Congress likely would tie reporting on performance on a growing number of measures to higher—or lower—payment, depending on how well facilities do.

Friday's upload includes two more quarters of data on previously posted measures. CMS Administrator Mark McClellan expressed some frustration at improvement efforts. Among the "starter set" measures, only vaccination to prevent pneumonia showed notable, though a small improvement as compared to the April posting, a CMS press release said.

"Certain processes appear to be well ingrained in U.S. hospitals—rates for aspirin at arrival and [patient] discharge and beta blocker at discharge for heart attack patients and assessment of blood oxygen levels for pneumonia remain high—but the rates for other measures indicate a continuing need for improvement efforts at the national level," McClellan said.

But Nancy Foster, vice president for quality at the American Hospital Association, said, "what you're seeing is the beginning of the reporting. We wouldn't expect to see the results of quality improvement efforts in the data yet."

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