Validity of CAUTI metric used for value-based purchasing questioned

Editor's Note

Two different measurement systems are used to track performance in lowering the rate of catheter-associated urinary tract infections (CAUTIs).

The Agency for Healthcare Research and Quality metric has shown a 28.2% decrease in CAUTIs since 2010, whereas the Centers for Disease Control and Prevention’s metric has shown a 3% to 6% increase in CAUTIs since 2009.

Differences in data acquisition and the definition of the denominator may explain the discrepancy. However, regardless of which factors are responsible for the widely varying results, the fact that the results are so different raises questions about the accuracy of the CAUTI rates that are currently used in value-based purchasing initiatives.

The Centers for Medicare & Medicaid Services may need to redefine the metric used for the CAUTI portion of their hospital acquired conditions reduction program. Data verification should be considered a high priority when financial incentives are being levied, the authors say.