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. 2017 Jun;52(3):1079-1098.
doi: 10.1111/1475-6773.12530. Epub 2016 Jul 24.

Impact of State Reporting Laws on Central Line-Associated Bloodstream Infection Rates in U.S. Adult Intensive Care Units

Hangsheng Liu  1 , Carolyn T A Herzig  2 , Andrew W Dick  1 , E Yoko Furuya  3 , Elaine Larson  4 , Julie Reagan  5 , Monika Pogorzelska-Maziarz  6 , Patricia W Stone  2
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Impact of State Reporting Laws on Central Line-Associated Bloodstream Infection Rates in U.S. Adult Intensive Care Units

Hangsheng Liu et al. Health Serv Res. 2017 Jun.

Abstract

Objective: To examine the effect of mandated state health care-associated infection (HAI) reporting laws on central line-associated bloodstream infection (CLABSI) rates in adult intensive care units (ICUs).

Data sources: We analyzed 2006-2012 adult ICU CLABSI and hospital annual survey data from the National Healthcare Safety Network. The final analytic sample included 244 hospitals, 947 hospital years, 475 ICUs, 1,902 ICU years, and 16,996 ICU months.

Study design: We used a quasi-experimental study design to identify the effect of state mandatory reporting laws. Several secondary models were conducted to explore potential explanations for the plausible effects of HAI laws.

Principal findings: Controlling for the overall time trend, ICUs in states with laws had lower CLABSI rates beginning approximately 6 months prior to the law's effective date (incidence rate ratio = 0.66; p < .001); this effect persisted for more than 6 1/2 years after the law's effective date. These findings were robust in secondary models and are likely to be attributed to changes in central line usage and/or resources dedicated to infection control.

Conclusions: Our results provide valuable evidence that state reporting requirements for HAIs improved care. Additional studies are needed to further explore why and how mandatory HAI reporting laws decreased CLABSI rates.

Keywords: CLABSI; Public reporting; health care-associated infections; hospitals; quality.

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Figures

Figure 1
Figure 1
Variation in the Timing of Law Effective Dates across Reporting States
Figure 2
Figure 2
Unadjusted Trends in CLABSI Rates in Two ICU Cohorts

  1. Notes: Central line–associated bloodstream infection (CLABSI) rates were measured as the number of CLABSI events per 1,000 patient days. The average CLABSI rate in reporting states declined from 1.77 in the first quarter of 2006 to 0.81 in the second quarter of 2012, a 54 percent reduction; the average CLABSI rate in nonreporting states decreased from 0.93 in the first quarter of 2006 to 0.55 in the second quarter of 2012, a 41 percent reduction.

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References

    1. Akaike, H. 1974. “A New Look at the Statistical Model Identification.” IEEE Transactions on Automatic Control 19 (6): 716–23.
    1. Backman, L. A. , Melchreit R., and Rodriguez R.. 2010. “Validation of the Surveillance and Reporting of Central Line‐Associated Bloodstream Infection Data to a State Health Department.” American Journal of Infection Control 38 (10): 832–8. - PubMed
    1. Berwick, D. M. , James B., and Coye M. J.. 2003. “Connections between Quality Measurement and Improvement.” Medical Care 41 (1 Suppl): I30–8. - PubMed
    1. Black, B. 2012. “Public Reporting of HAI Rates: What We (Mostly Don't) Know.” Clinical Governance: An International Journal 17 (2): 124–33.
    1. Caron, A. , and Neuhauser D.. 1999. “The Effect of Public Accountability on Hospital Performance: Trends in Rates for Cesarean Sections and Vaginal Births after Cesarean Section in Cleveland, Ohio.” Quality Management in Health Care 7 (2): 1–10. - PubMed

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