Premier Perspective Database: Comparative Effectiveness Research (CER) – Validated.

The Premier Perspective database covers 20% of the U.S. hospital discharges. Among other things, it is the largest inpatient drug utilization database in the U.S. The database contains complete billing and coding history on more than 45 million hospital inpatient discharges and more than 210 million hospital outpatient visits “from acute care facilities, ambulatory surgery centers and clinics across the nation.” In accordance with the agreements Premier has with its members, the level of detail available to support in-house and independent research is stunning.

A recent study that leveraged Premier’s data determined that in-hospital mortality is four times higher in patients with a hospital-acquired infection (HAI) than in those without. “Moreover, the length of stay in the ICU doubled for infected patients, up from a mean of 8.1 days to 15.8 days. In particular, hospital-acquired pneumonia was associated with 16.9 percent of ICU stays, bloodstream infection with 14.5 percent, ventilator-acquired pneumonia with 3.7 percent and surgical-site infection with 1.5 percent, according to the study. It also found that HAIs add an extra $16,000 to each ICU stay. In fact, an infected patient costs $37,500 per ICU stay, compared to $21,500 for a patient without. Two factors that made patients more at risk for an HAI were coming from the emergency department and being over 75 years old.

The findings reinforce recent research that found that patient infection rates, although down, still pose a major problem for hospitals. According to the Pennsylvania Health Care Cost Containment Council, infected patients stayed in the hospital three times longer than patients without, were far more likely to be readmitted with 30 days and were more than five times likely to die than patients without infections, FierceHealthcare previously reported.

Over the last 10 years a tremendous amount of attention has been given the subject of Hospital Acquired Infections (HAI). And with good reason — if 1,000 people read this post today, more than 20% of you can probably tell a story about a family member or a friend who “almost died” from an infection acquired during a stay at a hospital.

Medicare and Medicaid reimbursements are already being withheld or reduced if the patient has a HAI. The Affordable Care Act will follow suit and reduce “all payments to a hospital to 99% of the otherwise applicable rate if they are in the top 25% in hospital-acquired infections.” For Medicaid, PPACA would simply prohibit reimbursement for treatment related to HAIs.

Hospitals continue to do a much better job — for the most part — reducing the rate of HAIs. They have no choice. And the general steps they continue to take are actually working. Far better, however, that SCM professionals would know precisely where to look and/or where certain practices can be implemented that are going to deliver the biggest bang for the buck.

Data assets like Premier's Perspective Database are distinguishing themselves as key enablers for payers and providers seeking to decipher the cost/quality reimbursement calculus.

Reducing HAIs to levels that no one talks about anymore will continue to remain a front and center issue. The problem is just too well understood by the voting public.

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