title: State-Mandated Hospital Infection Reporting Is Not Associated With Decreased Pediatric Health Care-Associated Infections.
abstract: OBJECTIVE
  State governments increasingly mandate public reporting of central line-associated blood stream infections (CLABSIs). This study tests if hospitals located in states with state-mandated, facility-identified, pediatric-specific public CLABSI reporting have lower rates of CLABSIs as defined by the Agency for Healthcare Research and Quality's Pediatric Quality Indicator 12 (PDI12).
  
  
  METHODS
  Utilizing the Kids' Inpatient Databases from 2000 to 2009, we compared changes in PDI12 rates across three groups of states: states with public CLABSI reporting begun by 2006, states with public reporting begun by 2009 and never-reporting states. In the baseline period (2000-2003), no states mandated public CLABSI reporting. A multivariable, hospital-level random intercept, logistic regression was performed comparing changes in PDI12 rates in states with public reporting to changes in PDI12 rates in never-reporting states.
  
  
  RESULTS
  4,705,857 discharge records were eligible for PDI12. PDI12 rates significantly decreased in all reporting groups, comparing baseline to the post-public reporting period (2009): Never Reporters 88% decrease (95% CI, 86%-89%), Reporting Begun by 2006 90% decrease (95% CI, 83%-94%), and Reporting Begun by 2009 74% decrease (95% CI, 72%-76%). The Never Reporting Group had comparable decreases in PDI12 rates to the Reporting Begun by 2006 group (P = 0.4) and significantly larger decreases in PDI12 rates compared to the Reporting Begun by 2009 group (P < 0.001), despite having no states with public reporting.
  
  
  CONCLUSIONS
  Public CLABSI reporting alone appears to be insufficient to affect administrative data-based measures of pediatric CLABSI rates or children may be inadequately targeted in current public reporting efforts.
authors.affiliation: From the *Department of Pediatrics, The Children's Hospital at Montefiore, Bronx, New York; †Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina; ‡Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery; Johns Hopkins University School of Medicine; §Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, Maryland, ∥Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland; and ¶Children's Hospital Association, Alexandria, Virginia.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rinke
authors.forename: David G
authors.initials: DG
authors.lastname: Bundy
authors.forename: Fizan
authors.initials: F
authors.lastname: Abdullah
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Colantuoni
authors.forename: Yiyi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Marlene R
authors.initials: MR
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology*; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008297:Male; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012308:Risk Management / Q000379:methods / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D016270:United States Agency for Healthcare Research and Quality