Related Experiment Video
Updated: Apr 7, 2026
An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
Published on: June 24, 2025
Questionable validity of the catheter-associated urinary tract infection metric used for value-based purchasing
Lindsay E Calderon1, Kevin T Kavanagh2, Mara K Rice3
1Eastern Kentucky University, Department of Biological Sciences, Richmond, KY; Health Watch USA, Somerset, KY.
Abstract:
Catheter-associated urinary tract infections (CAUTIs) occur in 290,000 US hospital patients annually, with an estimated cost of $290 million. Two different measurement systems are being used to track the US health care system's performance in lowering the rate of CAUTIs. Since 2010, the Agency for Healthcare Research and Quality (AHRQ) metric has shown a 28.2% decrease in CAUTI, whereas the Centers for Disease Control and Prevention metric has shown a 3%-6% increase in CAUTI since 2009. Differences in data acquisition and the definition of the denominator may explain this discrepancy. The AHRQ metric analyzes chart-audited data and reflects both catheter use and care. The Centers for Disease Control and Prevention metric analyzes self-reported data and primarily reflects catheter care. Because analysis of the AHRQ metric showed a progressive change in performance over time and the scientific literature supports the importance of catheter use in the prevention of CAUTI, it is suggested that risk-adjusted catheter-use data be incorporated into metrics that are used for determining facility performance and for value-based purchasing initiatives.
Insights
Two metrics for catheter-associated urinary tract infections (CAUTIs) show conflicting trends. Incorporating catheter-use data into performance metrics is suggested for accurate healthcare quality assessment.
Area of Science:
- Healthcare quality improvement
- Infectious disease epidemiology
- Health informatics
Background:
- Catheter-associated urinary tract infections (CAUTIs) affect 290,000 US patients annually, costing $290 million.
- Two distinct metrics, AHRQ and CDC, track CAUTI rates but yield contradictory results.
- Discrepancies may stem from differences in data acquisition and denominator definitions.
Purpose of the Study:
- To analyze the discrepancy between AHRQ and CDC CAUTI metrics.
- To evaluate the impact of different data acquisition methods on reported CAUTI rates.
- To recommend improvements in healthcare performance metrics for CAUTI.
Main Methods:
- Comparative analysis of AHRQ (chart-audited, catheter use and care) and CDC (self-reported, catheter care) metrics.
- Review of scientific literature on CAUTI prevention and catheter use.
- Evaluation of performance trends over time for each metric.
Main Results:
- The AHRQ metric shows a 28.2% decrease in CAUTIs since 2010.
- The CDC metric indicates a 3%-6% increase in CAUTIs since 2009.
- The AHRQ metric reflects progressive performance changes, supported by literature on catheter use importance.
Conclusions:
- Divergent CAUTI metrics hinder accurate assessment of healthcare system performance.
- Risk-adjusted catheter-use data should be integrated into facility performance metrics.
- Improved metrics are crucial for value-based purchasing and effective CAUTI reduction strategies.
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01:26Urinary Tract Infection I: Introduction
01:25Urinary Tract Infection II: Pathophysiology
01:17Urinary Tract Infection IV: Nursing Management
01:28Microbiota of the Urogenital Tract