Hospital-acquired pressure ulcers: results from the national Medicare Patient Safety Monitoring System study

Abstract

Objectives: To determine the national and state incidence levels of newly hospital-acquired pressure ulcers (PUs) in Medicare beneficiaries and to describe the clinical and demographic characteristics and outcomes of these individuals.

Design: Retrospective secondary analysis of the national Medicare Patient Safety Monitoring System (MPSMS) database.

Setting: Medicare-eligible hospitals across the United States and select territories.

Participants: Fifty-one thousand eight hundred forty-two randomly selected hospitalized fee-for-service Medicare beneficiaries discharged from the hospital between January 1, 2006, and December 31, 2007.

Measurements: Data were abstracted from the MPSMS, which collects information on multiple hospital adverse events.

Results: Of the 51,842 individuals in the MPSMS 2006/07 sample, 2,313 (4.5%) developed at least one new PU during their hospitalization. The mortality risk-adjusted odds ratios were 2.81 (95% confidence interval (CI) = 2.44-3.23) for in-hospital mortality, 1.69 (95% CI=1.61-1.77) for mortality within 30 days after discharge, and 1.33 (95% CI = 1.23-1.45) for readmission within 30 days. The hospital risk-adjusted main length of stay was 4.8 days (95% CI = 4.7-5.0 days) for individuals who did not develop PUs and 11.2 days (95% CI = 10.19-11.4) for those with hospital-acquired PUs (P < .001). The Northeast region and Missouri had the highest incidence rates (4.6% and 5.9%, respectively).

Conclusion: Individuals who developed PUs were more likely to die during the hospital stay, have generally longer hospital lengths of stay, and be readmitted within 30 days after discharge.