Readmissions for Selected Infections Due to Medical Care: Expanding the Definition of a Patient Safety Indicator

Objective: Evaluate the Agency for Healthcare Research and Quality’s Patient Safety Indicator that identifies patients with selected infections that result from medical care during hospital inpatient treatment (secondary diagnosis of selected infection/infection not present at admission). Method: Using unique patient identifiers in New York inpatient hospitalization data, patients identified with a principal diagnosis of a selected infection (present at admission) were linked to any antecedent inpatient discharge. Results: Many patients with a principal diagnosis of selected infection (present at admission) were linked to a previous recent inpatient encounter. The hospital-level estimate of cases of selected infection resulting from inpatient treatment (secondary diagnosis of selected infection) increased 25 percent when patients identified with a principal diagnosis of selected infection were linked to antecedent inpatient discharges. Conclusions: The hospital-level estimate of cases of selected infection is an underestimate of infections resulting from inpatient treatment.