Abstract:
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CDC's National Healthcare Safety Network (NHSN), used by CDC and its partners for surveillance of healthcare-associated infections (HAIs), provides standardized infection ratios (SIRs) to participating hospitals to help promote healthcare quality. In 2011, the NHSN began reporting SIRs metrics of central line-associated bloodstream infection (CLABSI) incidence to the Center for Medicaid and Medicare Services (CMS) to evaluate hospital reporting and performance. A CLABSI SIR is the ratio of the observed to expected CLABSI incidence where the later was estimated using a log linear marginal model based on hospital and unit-level factors.
In 2011, there were 62,637 months of data summarizing CLABSI incidence reported to NHSN from 3,326 hospitals. Reliability-adjusted Hospital-level CLABSI that account for excessive variation due to exposure volume and unmeasured factors were produced using Bayesian analysis. These reliability-adjusted SIRs produce a ranking that can further be improved by obtaining triple-goal estimates thereby better supporting performance comparisons done by CMS to assess healthcare quality.
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