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Study Finds Differences in Two Data Sets Reporting on Hospital Acquired Pressure Ulcers

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A new study shows important differences between two sources of data used to track the rates and progress of hospital-acquired pressure ulcers (HAPUs). The hospital billing data used to calculate Medicare payment rates and penalties for hospitals may miss many of the HAPUs that patients are actually getting, the study finds.

And hospitals’ progress in reducing HAPUs is almost entirely because they prevented less costly and less dangerous early-stage HAPUs, and not the more severe kind, according to billing data.

In a new paper in the November issue of Health Affairs, the research team from the University of Michigan recommends better ways of tracking HAPUs for value-based purchasing policies. The program should use the same approach hospitals already use to track infections that patients develop during their stays, and adjust rates and penalties based on patients’ underlying risk.

Better data will mean more valid penalties for HAPUs, which affect 2.5 million patients in the U.S. alone, lead to the deaths of about 60,000 sufferers a year, and cost about $10 billion to treat.

The research team cites recent public reports of progress against HAPUs, which were based on surveillance chart review data from the Medicare Patient Safety Monitoring System that tracks trends in HAPUs and other hospital-acquired conditions.

Those reports found a decrease of 23 percent in the rate of HAPUs between 2010 and 2014, from 4 percent to just over 3 percent of inpatients, and concluded that this resulted in savings of more than $1 billion.

But the data used for these reports — which came from detailed medical chart reviews — aren’t the same as the billing data used to carry out the federal hospital payment policies for HAPUs.

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