Attach. 3 Q A.pdf

2009 MPSMS Algorithm

11. Catheter Associated Urinary Tract Infections

(UTI-Infection)

Medicare Patient Safety Monitoring System Annual Data Report: 2009 Findings

Hospital Discharges January 2009 to September 2009

2009 MPSMS Annual Data Report: Measure Algorithms Do not copy, cite or distribute without permission of Qualidigm® 10/2010

Catheter Associated Urinary Tract Infections (UTI) 17,975 Hospital Discharges

518 cases

8,566 cases No

Yes

16,687 cases No

No

Indwelling catheter in place on admission or on Straight Catheter Regime.

Yes

Yes

359 cases excluded

17,616 cases

UTI diagnosis on admission. 929 cases excluded

No

Physician diagnosis of UTI either the date of the catheterization, before the catheterization date, or unable to determine the date.

Indwelling Catheter Placed or Straight Catheterization Performed During Stay. 7,808 cases excluded

8,879 cases

313 cases excluded

Denominator

263 patients had a catheter associated UTI

263/8,566 = 3.1% of patients who didn’t have an indwelling catheter in place on admission, were not on a straight catheter regime prior to admission, and had no evidence of a UTI prior to the insertion of the catheter experienced a UTI.

No

Yes

8,287 cases excluded

No

Yes

Physician ordered antibiotics to treat the UTI. 16 cases excluded

Physician diagnosed UTI

279 cases

263 cases

2009 MPSMS Patient Characteristics

Patients Patients with Exposed Adverse Events Unweighted SE*

Total 8,566 263 3.07 0.19

Age:

<65 3,676 57 1.55 0.2 65-74 1,844 60 3.25 0.41 75-84 1,807 84 4.65 0.5 85 and over 1,239 62 5 0.62 Gender:

Female 5,369 179 3.33 0.25 Male 3,197 84 2.63 0.28 Race:

White 7,042 202 2.87 0.2 Black 877 37 4.22 0.68 Other 647 24 3.71 0.74 Diabetes:

Yes 2,559 116 4.53 0.41 No 6,007 147 2.45 0.2 Obesity:

Yes 1,948 68 3.49 0.42 No 6,618 195 2.95 0.21 Cerebrovascular Disease:

Yes 1,188 63 5.3 0.65 No 7,378 200 2.71 0.19 CHF/Pulmonary Edema:

Yes 2,653 131 4.94 0.42 No 5,913 132 2.23 0.19

COPD:

Yes 2,024 83 4.1 0.44 No 6,542 180 2.75 0.2 Smoking:

Yes 1,877 49 2.61 0.37 No 6,689 214 3.2 0.22 Corticosteroids:

Yes 473 14 2.96 0.78 No 8,093 249 3.08 0.19 Coronary Artery Disease:

Yes 3,199 130 4.06 0.35 No 5,367 133 2.48 0.21 Renal Disease:

Yes 1,607 89 5.54 0.57 No 6,959 174 2.5 0.19

*Standard Error COPD denotes Chronic Obstructive Pulmonary Disease

Medicare Patient Safety Monitoring System

Hospital Discharges from January 2009 to September 2009

Catheter Associated Urinary Tract Infections (N=8,566)

Adverse Event Rates % of exposed with event

Patient Characteristics

2009 MPSMS Annual Report: Patient Characteristics Do not copy cite or distribute without permission of Qualidigm® 10/2010

2009 MPSMS Outcomes

2009 MPSMS Annual Data Report: Outcomes Do not copy, cite or distribute without permission of Qualidigm® 10/2010

Cases Estimate 95% CI (L) 95% CI (U) Cases Estimate 95% CI (L) 95% CI (U) 263 8,303

Length of stay*, (mean, SD) 236 12.29 10.98 13.6 7,892 5.38 5.27 5.49 In-hospital mortality (%) 19 7.22 4.41 11.05 409 4.93 4.47 5.41

*Excluded > 60 days and in-hospital mortality

Medicare Patient Safety Monitoring System

January 2009 - September 2009 Hospital Discharges

Catheter Associated Urinary Tract Infections (UTI-Infection) 8,566 Eligible Cases

Patients who had at least one Adverse Event Patients without an Adverse Event

Outcomes