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Hospital-Acquired Infections Under Pay-for-Performance Systems: an Administrative Perspective on Management and

Rebecca A Vokes1, Gonzalo Bearman2, Gloria J Bazzoli3

  • 1Department of Health Administration, Virginia Commonwealth University, Richmond, VA, USA. ravokes@vcu.edu.

Current Infectious Disease Reports
|July 28, 2018
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Summary

Hospital-acquired infections (HAIs) threaten patient safety and healthcare finances under pay-for-performance (PFP) systems. Administrators must implement evidence-based policies to prevent HAIs and maintain reimbursement.

Keywords:
Alternative payment modelsCLABSICMSCMS paymentChange managementHealthcare administrationHealthcare managementHorizontal infection controlHorizontal vs vertical interventionHospital managementHospital reimbursementHospital-acquired conditionHospital-acquired infectionInfection preventionInfection prevention programKotter change managementKotter methodMedicaid reimbursementMedicare reimbursementNosocomial conditionOrganizational changePay for performancePreventing hospital infectionVertical infection control

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Area of Science:

  • Healthcare Management
  • Infection Control
  • Health Economics

Background:

  • Hospital-acquired infections (HAIs) present significant risks to patient safety.
  • HAIs impact the financial stability of healthcare facilities, especially under evolving payment models.
  • Pay-for-performance (PFP) systems link reimbursement to quality outcomes, including infection rates.

Purpose of the Study:

  • To examine how hospital-acquired infections affect financial reimbursement within pay-for-performance frameworks.
  • To outline the crucial role of healthcare administrators in infection prevention strategies.

Main Methods:

  • This review synthesizes existing literature on HAIs and PFP systems.
  • Analysis of evidence regarding the effectiveness of PFP in reducing HAIs.
  • Exploration of administrative strategies for infection control.

Main Results:

  • There is inconsistent evidence on whether PFP systems effectively reduce HAIs.
  • Evidence-based guidelines are proven to decrease the incidence of HAIs.
  • Failure to prevent HAIs can lead to substantial reimbursement losses for healthcare organizations under PFP.

Conclusions:

  • Healthcare administrators are pivotal in establishing and updating infection prevention policies.
  • Collaboration between administrators, front-line providers, and infection control teams is essential.
  • Effective change management is necessary to empower staff in preventing HAIs and ensuring fiscal viability.