{"indexed":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T07:15:58Z","timestamp":1509088558060},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2015,6]]},"abstract":"\n BACKGROUND<\/jats:title>\n Policymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non\u2013safety net hospitals.<\/jats:p>\n <\/jats:sec>\n \n DESIGN<\/jats:title>\n Interrupted time-series design.<\/jats:p>\n <\/jats:sec>\n \n SETTING AND PARTICIPANTS<\/jats:title>\n Nonfederal acute care hospitals that reported central line\u2013associated bloodstream infection and ventilator-associated pneumonia rates to the Centers for Disease Control and Prevention\u2019s National Health Safety Network from July 1, 2007, through December 31, 2013.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n We did not observe changes in the slope of targeted infection rates in the postpolicy period compared with the prepolicy period for either safety net (postpolicy vs prepolicy ratio, 0.96 [95% CI, 0.84\u20131.09]) or non\u2013safety net (0.99 [0.90\u20131.10]) hospitals. Controlling for prepolicy secular trends, we did not detect differences in an immediate change at the time of the policy between safety net and non\u2013safety net hospitals (P<\/jats:italic> for 2-way interaction, .87).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy did not have an impact, either positive or negative, on already declining rates of central line\u2013associated bloodstream infection in safety net or non\u2013safety net hospitals. Continued evaluations of the broad impact of payment policies on safety net hospitals will remain important as the use of financial incentives and penalties continues to expand in the United States.<\/jats:p>\n \n Infect Control Hosp Epidemiol<\/jats:italic> 2015;00(0): 1\u20137<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/ice.2015.38","type":"article-journal","created":{"date-parts":[[2015,3,3]],"date-time":"2015-03-03T06:24:19Z","timestamp":1425363859000},"page":"649-655","source":"Crossref","is-referenced-by-count":8,"title":"Impact of Medicare\u2019s Hospital-Acquired Condition Policy on Infections in Safety Net and Non\u2013Safety Net Hospitals","prefix":"10.1017","volume":"36","author":[{"given":"Louise Elaine","family":"Vaz","affiliation":[]},{"given":"Kenneth P.","family":"Kleinman","affiliation":[]},{"given":"Alison Tse","family":"Kawai","affiliation":[]},{"given":"Robert","family":"Jin","affiliation":[]},{"given":"William J.","family":"Kassler","affiliation":[]},{"given":"Patricia S.","family":"Grant","affiliation":[]},{"given":"Melisa D.","family":"Rett","affiliation":[]},{"given":"Donald A.","family":"Goldmann","affiliation":[]},{"given":"Michael S.","family":"Calderwood","affiliation":[]},{"given":"Stephen B.","family":"Soumerai","affiliation":[]},{"given":"Grace M.","family":"Lee","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2015,3,3]]},"reference":[{"key":"S0899823X15000380_ref32","DOI":"10.1377\/hlthaff.28.6.w1160","doi-asserted-by":"publisher"},{"key":"S0899823X15000380_ref35","DOI":"10.1377\/hlthaff.28.5.1485","doi-asserted-by":"publisher"},{"key":"S0899823X15000380_ref17","DOI":"10.1016\/j.ajic.2007.07.002","doi-asserted-by":"publisher"},{"key":"S0899823X15000380_ref16","DOI":"10.1086\/604719","doi-asserted-by":"publisher"},{"key":"S0899823X15000380_ref15","DOI":"10.1007\/s11606-011-1935-y","doi-asserted-by":"publisher"},{"key":"S0899823X15000380_ref9","DOI":"10.1377\/hlthaff.28.5.1494","doi-asserted-by":"publisher"},{"key":"S0899823X15000380_ref45","first-page":"1","year":"2011","volume-title":"The Impact of the Affordable Care Act on the Safety Net"},{"key":"S0899823X15000380_ref14","volume":"56","first-page":"319","year":"2011","journal-title":"J Healthc 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