Reporting of sepsis cases for performance measurement versus for reimbursement in New York State

Critical Care Medicine

Volumn 46, Issue 5, 2018, Pages 666-673

  Prescott, Hallie C ^a,b   Cope, Tara M ^c,g   Gesten, Foster C ^c,h   Ledneva, Tatiana A ^c   Friedrich, Marcus E ^c   Iwashyna, Theodore J ^a,b   Osborn, Tiffany M ^d   Seymour, Christopher W ^e   Levy, Mitchell M ^f  

^a UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

^b VA ANN ARBOR HEALTHCARE SYSTEM   (United States)

^c NEW YORK STATE DEPARTMENT OF HEALTH   (United States)

^d WASHINGTON UNIVERSITY   (United States)

^e UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^f BROWN UNIVERSITY   (United States)

^g SIENA COLLEGE   (United States)

^h NEW YORK PRESBYTERIAN HOSPITAL   (United States)

Author keywords

epidemiology; government regulation; hospital mortality; quality of healthcare

Indexed keywords

ARTICLE; COHORT ANALYSIS; CONTROLLED STUDY; CORRELATION COEFFICIENT; EMERGENCY CARE; GOVERNMENT REGULATION; HOSPITAL DISCHARGE; HUMAN; MAJOR CLINICAL STUDY; OBSERVATIONAL STUDY; PATIENT; PRIORITY JOURNAL; REIMBURSEMENT; SEPSIS; SEPTIC SHOCK; COMPARATIVE STUDY; HEALTH CARE QUALITY; HOSPITAL; LEGISLATION AND JURISPRUDENCE; MANDATORY REPORTING; MORTALITY; NEW YORK;

GOVERNMENT REGULATION; HOSPITALS; HUMANS; MANDATORY REPORTING; NEW YORK; PATIENT DISCHARGE; QUALITY INDICATORS, HEALTH CARE; REIMBURSEMENT MECHANISMS; SEPSIS;

EID: 85053197505     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0000000000003005     Document Type: Article

References (32)

1. Liu V, Escobar GJ, Greene JD, et al: Hospital deaths in patients with sepsis from 2 independent cohorts. JAMA 2014; 312:90-92
2. Moore TC: National Inpatient Hospital Costs: The Most Expensive Hospital Conditions by Payer, 2013. HCUP Statistical Brief #204. Rockville, MD, Agency for Healthcare Research and Quality, 2016. Available at: https://hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.pdf. Accessed February 14, 2017
3. Dellinger RP, Levy MM, Rhodes A, et al; Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup: Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39:165-228
4. Sepsis Regulations: Guidance Document 405.4 (a)(4). Available at: https://www.health.ny.gov/regulations/publichealthlaw/section/ 405/. Accessed February 14, 2017
5. Tuttle D, Panzer RJ, Baird T: Using administrative data to improve compliance with mandatory state event reporting. Jt Comm J Qual Improv 2002; 28:349-358
6. Tuttle D, Holloway R, Baird T, et al: Electronic reporting to improve patient safety. Qual Saf Health Care 2004; 13:281-286
7. Rhee C, Gohil S, Klompas M: Regulatory mandates for sepsis care-reasons for caution. N Engl J Med 2014; 370:1673-1676
8. New York State Department of Health: Statewide Planning and Research Cooperative System. Available at: https://www.health. ny.gov/statistics/sparcs/. Accessed February 14, 2017
9. Governor Cuomo Announces New York State to Lead the Nation in Fighting Sepsis the #1 Killer in Hospitals and Make Major Improvements in Pediatric Care Through "Rory's Regulations," 2013. Available at: http://www.governor.ny.gov/news/governor-cuomo-announcesnew-york-state-lead-nation-fighting-sepsis-1-killer-hospitals-andmake. Accessed February 14, 2017
10. Updated Proposed Sepsis Regulation Containing Minor Technical/ Formatting Revisions with Impact Statements-updatedsepsisregulation. pdf. Available at: https://www.health.ny.gov/facilities/public healthandhealthplanningcouncil/meetings/2013-04-11/docs/ updatedsepsisregulation.pdf. Accessed February 14, 2017
11. Levy MM, Fink MP, Marshall JC, et al: 2001 SCCM/ESICM/ACCP/ ATS/SIS international sepsis definitions conference. Crit Care Med 2003; 31:1250-1256
12. New York State Department of Health: New York State Report on Sepsis Care Improvement Initiative: Hospital Quality Performance. 2015. Available at: https://www.health.ny.gov/press/reports/docs/2015 sepsiscareimprovementinitiative.pdf. Accessed October 3, 2017
13. Seymour CW, Gesten F, Prescott HC, et al: Time to treatment and mortality during mandated emergency care for sepsis. N Engl J Med 2017; 376:2235-2244
14. Iwashyna TJ, Odden A, Rohde J, et al: Identifying patients with severe sepsis using administrative claims: Patient-level validation of the angus implementation of the international consensus conference definition of severe sepsis. Med Care 2014; 52:e39-e43
15. Jolley RJ, Sawka KJ, Yergens DW, et al: Validity of administrative data in recording sepsis: A systematic review. Crit Care 2015; 19:139
16. Dombrovskiy VY, Martin AA, Sunderram J, et al: Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: A trend analysis from 1993 to 2003. Crit Care Med 2007; 35:1244-1250
17. Angus DC, Linde-Zwirble WT, Lidicker J, et al: Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001; 29:1303-1310
18. Charlson ME, Pompei P, Ales KL, et al: A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis 1987; 40:373-383
19. Deyo RA, Cherkin DC, Ciol MA: Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992; 45:613-619
20. USDA ERS: Rural-Urban Commuting Area Codes. Available at: https://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes/. Accessed November 28, 2017
21. Sjoding MW, Iwashyna TJ, Dimick JB, et al: Gaming hospitallevel pneumonia 30-day mortality and readmission measures by legitimate changes to diagnostic coding. Crit Care Med 2015; 43:989-995
22. Rhee C, Kadri SS, Danner RL, et al: Diagnosing sepsis is subjective and highly variable: A survey of intensivists using case vignettes. Crit Care 2016; 20:89
23. Liu VX, Morehouse JW, Marelich GP, et al: Multicenter implementation of a treatment bundle for patients with sepsis and intermediate lactate values. Am J Respir Crit Care Med 2016; 193:1264-1270
24. Poeze M, Ramsay G, Gerlach H, et al: An international sepsis survey: A study of doctors' knowledge and perception about sepsis. Crit Care 2004; 8:R409-R413
25. Jolley RJ, Yergens DW, Quan H, et al: Physician recognition and documentation of sepsis. A comparison of the 2001 ACCP/SCCM consensus conference definitions and physician documented diagnosis. Intensive Care Med Exp 2015; 3:A224
26. Bellani G, Laffey JG, Pham T, et al; LUNG SAFE Investigators; ESICM Trials Group: Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016; 315:788-800
27. Weiss CH, Baker DW, Weiner S, et al: Low tidal volume ventilation use in acute respiratory distress syndrome. Crit Care Med 2016; 44:1515-1522
28. Cooke CR, Iwashyna TJ: Sepsis mandates: Improving inpatient care while advancing quality improvement. JAMA 2014; 312:1397-1398
29. Seymour CW, Liu VX, Iwashyna TJ, et al: Assessment of clinical criteria for sepsis: For the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 2016; 315:762-774
30. Whittaker SA, Mikkelsen ME, Gaieski DF, et al: Severe sepsis cohorts derived from claims-based strategies appear to be biased toward a more severely ill patient population. Crit Care Med 2013; 41:945-953
31. Lindenauer PK, Lagu T, Shieh MS, et al: Association of diagnostic coding with trends in hospitalizations and mortality of patients with pneumonia, 2003-2009. JAMA 2012; 307:1405-1413
32. Seymour CW, Kahn JM, Cooke CR, et al: Prediction of critical illness during out-of-hospital emergency care. JAMA 2010; 304:747-754