Comparison of Administrative Data Versus Infection Control Data in Identifying Central Line-Associated Bloodstream...

Area of Science:

• Healthcare quality measurement
• Pediatric infection control
• Health services research

Background:

• Central line-associated bloodstream infections (CLABSIs) are a significant cause of morbidity and mortality in pediatric patients.
• Provider-preventable conditions, including CLABSIs, are no longer reimbursed by Medicare and Medicaid Services since July 2012.
• Accurate identification of CLABSIs is crucial for quality improvement and reimbursement purposes.

Purpose of the Study:

• To compare the accuracy of administrative data versus infection control data in identifying CLABSIs.
• To evaluate the sensitivity and specificity of administrative data for CLABSI detection.
• To inform healthcare quality reporting and reimbursement policies.

Main Methods:

• Retrospective chart reviews were conducted in three children's hospitals.
• CLABSIs were identified using both administrative data diagnostic coding and hospital infection control department records.
• Infection identification was standardized using Centers for Disease Control and Prevention (CDC) clinical criteria, as reported to the National Healthcare Safety Network (NHSN).

Main Results:

• A total of 166 CLABSIs were identified across 35,698 discharges in 2010.
• Administrative data demonstrated a sensitivity of 34.78% and a specificity of 99.92% when compared to CDC/NHSN criteria.
• The positive predictive value for administrative data was 63.16%, and the negative predictive value was 99.75%.

Conclusions:

• Administrative data and NHSN criteria yield significantly different counts of CLABSIs.
• The low sensitivity of administrative data suggests undercounting of CLABSIs, potentially impacting quality metrics and reimbursement.
• Discrepancies necessitate careful consideration when using administrative data for CLABSI surveillance and quality assessment.