Calculating the frequency of serious reportable adverse events and hospital-acquired conditions

Area of Science:

• Healthcare Administration
• Patient Safety
• Health Informatics

Background:

• Centers for Medicare and Medicaid Services (CMS) mandates require Medicare Advantage Organizations (MAOs) to report serious adverse events and hospital-acquired conditions.
• Existing reporting mandates from state and health insurance plans add complexity.

Purpose of the Study:

• To analyze the current methodology for reporting adverse events and hospital-acquired conditions.
• To propose an alternative, more effective reporting approach.

Main Methods:

• Analysis of existing CMS reporting requirements for adverse events and hospital-acquired conditions.
• Development and proposal of a rate-based formula for data analysis.

Main Results:

• The current reporting methodology may not yield the most useful information for improving patient care.
• A rate-based formula approach is proposed as a superior alternative for data analysis.

Conclusions:

• Current adverse event reporting by MAOs can be improved.
• Rate-based formulas offer a more informative approach to analyzing healthcare-associated conditions and patient safety data.