Success in efforts to prevent HAPUs may depend on data sources

Editor's Note

Transitioning from administrative data to chart-based surveillance review to measure hospital-acquired pressure ulcers (HAPUs) and accounting for HAPU severity could improve the validity of measures for assessing the clinical and financial impact of value-based purchasing interventions, this study finds.

Assessing HAPU incidence, severity, and trends using administrative data for 2009-2004 from three states, researchers found the HAPU incidence was about one-twentieth of that found in chart-based surveillance review data.

HAPU incidence in administrative data declined, but 96% of the change was because of a decline in the incidence of less severe HAPUs. Advanced-stage HAPU rates remained the same at 0.04%.

The researchers recommend that policy makers use the same approach for HAPUs as that now used to track and report hospital-acquired infections (ie, surveillance review) and adjust rates and penalties based on patients’ underlying risk.