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Report Cards for Hospital-Acquired Bedsores: How Good Are the Grades?
The data Medicare uses to publicly report hospital rates of patients developing pressure ulcers (bedsores) is not an accurate source for comparing hospitals on how well they prevent the condition, according to a new study from the University of Michigan.
Bedsores are among many common hospital-acquired conditions that Medicare’s Hospital Compare website reports in an effort to help consumers compare the quality of their care at different hospitals.
Hospital bedsore rates varied widely based on how the data were collected, unfairly making some hospitals appear to fare better or worse than others, according to the new findings, which appear in the Annals of Internal Medicine.
Overall, bedsore rates were about 10 times lower when they were based on billing data compared with rates calculated from bedside exams by nurses. In bedside exams, trained teams of independent nurses record rates by periodically evaluating patients for bedsores through a comprehensive skin exam. In contrast, hospital-acquired pressure ulcer cases are identified by hospital coders generating billing data based on how physicians and wound care teams describe wounds in their medical record notes.
“Our findings provide a strong case for removing hospital rates for pressure ulcers from the Medicare’s Hospital Compare website in order to prevent comparisons that may be misleading to patients and policymakers,” said lead author Jennifer Meddings, MD, MSc.
Source: University of Michigan; October 14, 2013.