Complex hospital infection data confuses consumers

November 23, 2015

Patients have difficulty deciphering complex numeric data on healthcare-associated infections used by the Centers for Medicare and Medicaid Services (CMS) to help consumers choose hospitals, according to a new study published online today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

"Healthcare has made great strides to engage individuals to take a more active role in their care through the public reporting of data," said lead author Max Masnick, PhD, University of Maryland School of Medicine. "However, presenting healthcare-acquired infection data is difficult. We found that the current way public HAI data are communicated is confusing for consumers who are trying to make informed decisions on their care."

The collection and publication of hospital-acquired infection (HAI) data are a key element of the Affordable Care Act and other recent healthcare reform legislation as part of an effort to improve care by having consumers make informed choices. These data are made available to the public via the CMS Hospital Compare website.

Researchers at the University of Maryland School of Medicine conducted a cross-sectional survey among 110 randomly selected patients at the University of Maryland Medical Center. The survey asked participants to compare two hypothetical hospitals' frequency of catheter-associated urinary tract infections, using data displayed in the same form currently used on CMS Hospital Compare for use by the general public.

When given only written descriptions of the HAI prevalence in two hospitals, nearly three in 10 participants (28 percent) were unable to accurately identify the better hospital. When participants were given both written descriptions and numeric data together, as presented on the CMS website, comprehension worsened, with 40 percent unable to correctly identify the better hospital. The authors note that based on these findings, members of the general public may reach incorrect conclusions when comparing hospitals using the current HAI reporting format.

"HAI data are made accessible to the public to help improve hospital quality and increase transparency among healthcare systems. We need more effective ways to communicate this information," said Masnick. Masnick says he and his co-authors are working on ways CMS could improve their website.
Max Masnick, Daniel Morgan, John Sorkin, Elizabeth Kim, Jessica Brown, Penny Rheingans, Anthony Harris. "Lack of Patient Understanding of Hospital Acquired Infection Data Published on the Centers for Medicare and Medicaid Services (CMS) Hospital Compare Website." Web (November 23, 2015).

About ICHE

Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13th out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

SHEA is a professional society representing physicians and other healthcare professionals around the world with expertise and passion in healthcare epidemiology, infection prevention, and antimicrobial stewardship. SHEA's mission is to prevent and control healthcare-associated infections, improve the use of antibiotics in healthcare settings, and advance the field of healthcare epidemiology. SHEA improves patient care and healthcare worker safety in all healthcare settings through the critical contributions of healthcare epidemiology and improved antibiotic use. The society leads this specialty by promoting science and research, advocating for effective policies, providing high-quality education and training, and developing appropriate guidelines and guidance in practice. Visit SHEA online at, and @SHEA_Epi.

About Cambridge Journals

Cambridge University Press publishes over 350 peer-reviewed academic journals across a wide spread of subject areas, in print and online. Many of these journals are leading academic publications in their fields and together form one of the most valuable and comprehensive bodies of research available today.

For further information about Cambridge Journals, visit

About Cambridge University Press

Cambridge University Press is part of the University of Cambridge. It furthers the University's mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence.

Its extensive peer-reviewed publishing lists comprise 45,000 titles covering academic research, professional development, over 350 research journals, school-level education, English language teaching and bible publishing.

Playing a leading role in today's international market place, Cambridge University Press has more than 50 offices around the globe, and it distributes its products to nearly every country in the world.

For further information about Cambridge University Press, visit

Society for Healthcare Epidemiology of America

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