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Invited Commentary
August 2015

More Evidence That the Use of Venous Thromboembolism Rates as Hospital Quality Measures May Be Off the Mark

Author Affiliations
  • 1Department of Surgery, Harbor–University of California, Los Angeles, Medical Center, Torrance, California
JAMA Surg. 2015;150(8):721. doi:10.1001/jamasurg.2015.1065

The Centers for Medicare & Medicaid Services will implement the Hospital Acquired Condition (HAC) Reduction Program in 2015, as mandated by the Patient Protection and Affordable Care Act. The effect will be a 1% reduction to Medicare payments for hospitals in the top quartile of risk-adjusted HAC rates. An individual hospital’s HAC rate will be based on 2 measurement domains. One will include health careassociated infection (central catheterassociated bloodstream infections and catheter-associated urinary tract infections). The other will be a composite measure of several Patient Safety Indicators (PSIs). Postoperative venous thromboembolism (VTE) is included in the PSI 90 composite and, in fact, is one of the more heavily weighted indicators. Therefore, the prevention of VTE is high on the radar of all US hospitals, and this has led to an increased focus on VTE prophylaxis and prevention.

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