Bayesian Ranking of Health Care--Associated Infection Metrics Using Triple-Goal Estimates

• Activity Number: 644
• Type: Contributed
• Date/Time: Thursday, August 13, 2015 : 8:30 AM to 10:20 AM
• Sponsor: Section on Bayesian Statistical Science
• Author(s): Jonathan R. Edwards*
• Companies: CDC
• Keywords: Healthcare ; Infection ; Bayesian Ranking

Abstract

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.