原创力文档reduction in clostridium difficile infection rates after mandatory hospital public reporting findings from a longitudinal cohort study in canada梭状芽胞杆菌减少感染率后强制医院公开报道发现在加拿大从纵向队列研究.pdfVIP
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reduction in clostridium difficile infection rates after mandatory hospital public reporting findings from a longitudinal cohort study in canada梭状芽胞杆菌减少感染率后强制医院公开报道发现在加拿大从纵向队列研究
Reduction in Clostridium difficile Infection Rates after
Mandatory Hospital Public Reporting: Findings from a
Longitudinal Cohort Study in Canada
1,2 1,3 1 1 1,3,4,5
Nick Daneman *, Therese A. Stukel , Xiaomu Ma , Marian Vermeulen , Astrid Guttmann
1 Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, 2 Division of Infectious Diseases, Department of Medicine, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, Ontario, Canada, 3 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada, 4 Division of
Paediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada, 5 Department of Paediatrics, University of Toronto, Ontario, Canada
Abstract
Background: The role of public reporting in improving hospital quality of care is controversial. Reporting of hospital-
acquired infection rates has been introduced in multiple health care systems, but its relationship to infection rates has been
understudied. Our objective was to determine whether mandatory public reporting by hospitals is associated with a
reduction in hospital rates of Clostridium difficile infection.
Methods and Findings: We conducted a longitudinal, population-based cohort study in Ontario (Canada’s largest province)
between April 1, 2002, and March 31, 2010. We included all patients (.1 y old) admitted to 180 acute care hospitals. Using
Poisson regression, we developed a model to predict hospital- and age-specific monthly rates of C. difficile disease per
10,000 patient-days prior to introduction of public reporting on September 1, 2008. We then compared observed monthly
rates of C. difficile infection in the post-intervention
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