TY - JOUR
T1 - The Financial Incentive for Hospitals to Prevent Nosocomial Infections Under the Prospective Payment System
T2 - An Empirical Determination From a Nationally Representative Sample
AU - Haley, R. W.
AU - White, J. W.
AU - Culver, D. H.
AU - Hughes, J. M.
PY - 1987/3/27
Y1 - 1987/3/27
N2 - To clarify the financial incentives for hospitals to prevent nosocomial infections, we analyzed 9423 nosocomial infections identified in 169526 admissions selected randomly from the adult admissions to a random sample of US hospitals. By classifying each admission into a baseline diagnosis related group (DRG) (after first excluding all diagnoses of nosocomial infection) and a final DRG (after including these diagnoses), we found that only 5% to 18% of nosocomial infections would have caused the admission to be reclassified to a higher-paying DRG, depending on the extent to which physicians recorded nosocomial infection diagnoses in patients’ medical records. The extra payment from the reclassification, averaged over all nosocomial infections, would have been no more than $93 per infection (in 1985 reimbursement rates), constituting only 5% of the hospitals’ costs for treating these infections. Thus, at least 95% of the cost savings obtained from preventing nosocomial infections represents financial gains to the hospital.
AB - To clarify the financial incentives for hospitals to prevent nosocomial infections, we analyzed 9423 nosocomial infections identified in 169526 admissions selected randomly from the adult admissions to a random sample of US hospitals. By classifying each admission into a baseline diagnosis related group (DRG) (after first excluding all diagnoses of nosocomial infection) and a final DRG (after including these diagnoses), we found that only 5% to 18% of nosocomial infections would have caused the admission to be reclassified to a higher-paying DRG, depending on the extent to which physicians recorded nosocomial infection diagnoses in patients’ medical records. The extra payment from the reclassification, averaged over all nosocomial infections, would have been no more than $93 per infection (in 1985 reimbursement rates), constituting only 5% of the hospitals’ costs for treating these infections. Thus, at least 95% of the cost savings obtained from preventing nosocomial infections represents financial gains to the hospital.
UR - http://www.scopus.com/inward/record.url?scp=0023107007&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0023107007&partnerID=8YFLogxK
U2 - 10.1001/jama.1987.03390120073026
DO - 10.1001/jama.1987.03390120073026
M3 - Article
C2 - 3102768
AN - SCOPUS:0023107007
SN - 0098-7484
VL - 257
SP - 1611
EP - 1614
JO - JAMA: The Journal of the American Medical Association
JF - JAMA: The Journal of the American Medical Association
IS - 12
ER -