Evidence map›Paper›PMID 29669607›Full record

ArticleInfection control and hospital epidemiology2018

The Impact of the Medicaid Healthcare-Associated Condition Program on Mediastinitis Following Coronary Artery Bypass Graft.

Heather E Hsu, Alison Tse Kawai, Rui Wang, Maximilian S Jentzsch, Chanu Rhee, Kelly Horan, Robert Jin, Donald Goldmann, Grace M Lee

Open access · greenAbstract readComparative Study
In one paragraph

Article in Infection control and hospital epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Heather E Hsu1Department of Medicine,Boston Children's Hospital,Boston,Massachusetts.
Alison Tse Kawai2Department of Population Medicine,Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
Rui Wang2Department of Population Medicine,Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
Maximilian S Jentzsch2Department of Population Medicine,Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
Chanu Rhee2Department of Population Medicine,Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
Kelly Horan2Department of Population Medicine,Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
Robert Jin2Department of Population Medicine,Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
Donald Goldmann1Department of Medicine,Boston Children's Hospital,Boston,Massachusetts.
Grace M Lee2Department of Population Medicine,Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
Harvard University · USHarvard Pilgrim Health Care · USBoston Children's Hospital · USInstitute for Healthcare Improvement · US

Funding

Training in Child Health Services Research and Implementation ScienceT32HS000063 · AHRQ · CHILDREN'S HOSPITAL BOSTON · PI GARABEDIAN, LAURA FADEN, WALSH, KATHLEEN ELIZABETH · 1994 to 2024
$7.6M
Preventing Avoidable Infectious Complications by Adjusting Payment (PAICAP)IIR01HS018414 · AHRQ · HARVARD PILGRIM HEALTH CARE, INC. · PI LEE, GRACE M · 2009 to 2014
$3.4M
Objective Evaluation of Variation in Sepsis Incidence, Mortality, and CareK08HS025008 · AHRQ · HARVARD PILGRIM HEALTH CARE, INC. · PI RHEE, CHANU · 2017 to 2019
$450k
AHRQ HHS K08 HS025008AHRQ HHS R01 HS018414AHRQ HHS T32 HS000063
6 · The paper itself

Abstract

OBJECTIVEIn 2012, the Centers for Medicare and Medicaid Services expanded a 2008 program that eliminated additional Medicare payment for mediastinitis following coronary artery bypass graft (CABG) to include Medicaid. We aimed to evaluate the impact of this Medicaid program on mediastinitis rates reported by the National Healthcare Safety Network (NHSN) compared with the rates of a condition not targeted by the program, deep-space surgical site infection (SSI) after knee replacement.DESIGNInterrupted time series with comparison group.METHODSWe included surveillance data from nonfederal acute-care hospitals participating in the NHSN and reporting CABG or knee replacement outcomes from January 2009 through June 2017. We examined the Medicaid program's impact on NHSN-reported infection rates, adjusting for secular trends. The data analysis used generalized estimating equations with robust sandwich variance estimators.RESULTSDuring the study period, 196 study hospitals reported 273,984 CABGs to the NHSN, resulting in 970 mediastinitis cases (0.35%), and 294 hospitals reported 555,395 knee replacements, with 1,751 resultant deep-space SSIs (0.32%). There was no significant change in incidence of either condition during the study. Mediastinitis models showed no effect of the 2012 Medicaid program on either secular trend during the postprogram versus preprogram periods (P=.70) or an immediate program effect (P=.83). Results were similar in sensitivity analyses when adjusting for hospital characteristics, restricting to hospitals with consistent NHSN reporting or incorporating a program implementation roll-in period. Knee replacement models also showed no program effect.CONCLUSIONSThe 2012 Medicaid program to eliminate additional payments for mediastinitis following CABG had no impact on reported mediastinitis rates.Infect Control Hosp Epidemiol 2018;39:694-700.

Indexed as

Cross InfectionArthroplasty, Replacement, KneeCenters for Medicare and Medicaid Services, U.S.Coronary Artery BypassDatabases, FactualEconomics, HospitalHealth PolicyHospitalsHumansInterrupted Time Series AnalysisMediastinitisMedicaidSurgical Wound InfectionUnited States

Identifiers

PMID29669607
PMCPMC5957779
OpenAlexW2800484565

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.