{"indexed":{"date-parts":[[2018,2,15]],"date-time":"2018-02-15T05:22:23Z","timestamp":1518672143495},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2016,1]]},"abstract":"\n BACKGROUND<\/jats:title>\n Case mix index (CMI) has been used as a facility-level indicator of patient disease severity. We sought to evaluate the potential for CMI to be used for risk adjustment of National Healthcare Safety Network (NHSN) healthcare-associated infection (HAI) data.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n NHSN facility-wide laboratory-identified Clostridium difficile<\/jats:italic> infection event data from 2012 were merged with the fiscal year 2012 Inpatient Prospective Payment System (IPPS) Impact file by CMS certification number (CCN) to obtain a CMI value for hospitals reporting to NHSN. Negative binomial regression was used to evaluate whether CMI was significantly associated with healthcare facility-onset (HO) CDI in univariate and multivariate analysis.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Among 1,468 acute care hospitals reporting CDI data to NHSN in 2012, 1,429 matched by CCN to a CMI value in the Impact file. CMI (median, 1.49; interquartile range, 1.36\u20131.66) was a significant predictor of HO CDI in univariate analysis (P<\/jats:italic>&lt;.0001). After controlling for community onset CDI prevalence rate, medical school affiliation, hospital size, and CDI test type use, CMI remained highly significant (P<\/jats:italic>&lt;.0001), with an increase of 0.1 point in CMI associated with a 3.4% increase in the HO CDI incidence rate.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n CMI was a significant predictor of NHSN HO CDI incidence. Additional work to explore the feasibility of using CMI for risk adjustment of NHSN data is necessary.<\/jats:p>\n \n Infect. Control Hosp. Epidemiol.<\/jats:italic> 2015;37(1):19\u201325<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/ice.2015.252","type":"article-journal","created":{"date-parts":[[2015,10,21]],"date-time":"2015-10-21T05:17:33Z","timestamp":1445404653000},"page":"19-25","source":"Crossref","is-referenced-by-count":5,"title":"Evaluating the Use of the Case Mix Index for Risk Adjustment of Healthcare-Associated Infection Data: An Illustration using Clostridium difficile Infection Data from the National Healthcare Safety Network","prefix":"10.1017","volume":"37","author":[{"given":"Nicola D.","family":"Thompson","affiliation":[]},{"given":"Jonathan R.","family":"Edwards","affiliation":[]},{"given":"Margaret A.","family":"Dudeck","affiliation":[]},{"given":"Scott K.","family":"Fridkin","affiliation":[]},{"given":"Shelley S.","family":"Magill","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2015,10,21]]},"reference":[{"key":"S0899823X15002524_ref24","DOI":"10.1186\/1472-6963-6-125","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref25","DOI":"10.1086\/644751","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref21","year":"2011","volume-title":"Negative Binomial Regression"},{"key":"S0899823X15002524_ref31","DOI":"10.1001\/jama.2014.15372","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref30","DOI":"10.7326\/M14-1601","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref17","first-page":"35","year":"1989","journal-title":"Health Affairs"},{"key":"S0899823X15002524_ref16","DOI":"10.1093\/jac\/dkn275","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref15","first-page":"1","year":"2014","journal-title":"Perspect Health Info Manag"},{"key":"S0899823X15002524_ref9","DOI":"10.1086\/674389","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref14","DOI":"10.1089\/pop.2013.0002","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref8","DOI":"10.1086\/662016","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref13","DOI":"10.1086\/678069","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref7","DOI":"10.1186\/1471-2334-9-145","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref12","DOI":"10.1016\/0003-4975(94)91721-3","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref6","DOI":"10.1086\/591457","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref11","DOI":"10.1016\/j.ajic.2013.09.002","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref5","DOI":"10.1016\/j.ajic.2005.04.001","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref10","DOI":"10.1086\/674412","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref4","DOI":"10.1001\/archinte.162.21.2437","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref28","volume":"5","first-page":"145","year":"2007","journal-title":"J Support Oncol"},{"key":"S0899823X15002524_ref26","DOI":"10.1093\/cid\/cir672","doi-asserted-by":"publisher"},{"key":"S0899823X15002524_ref22","year":"1996"}],"container-title":"Infection Control & Hospital Epidemiology","original-title":[],"link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X15002524","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,4,23]],"date-time":"2017-04-23T01:55:52Z","timestamp":1492912552000},"score":1.0,"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,21]]},"references-count":22,"alternative-id":["S0899823X15002524"],"URL":"http:\/\/dx.doi.org\/10.1017\/ice.2015.252","relation":{"cites":[]},"ISSN":["0899-823X","1559-6834"],"subject":["Microbiology (medical)","Epidemiology","Infectious Diseases"],"container-title-short":"Infect. Control Hosp. Epidemiol."}