Letters
Health services administration Infectious diseases
Volume 200 - Issue 5

How should we interpret hospital infection statistics?

Authors:  Allen C Cheng and Leon J Worth

Med J Aust 2014; 200 (5): 257-259. || doi: 10.5694/mja14.00101
Published online: 17 March 2014
However rates of Staphylococcus aureus bacteraemia are reported, the aim should be to reduce them
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In reply: We thank Watson for her comments and agree that there is probably room for improvement. However, for most hospitals that fall within the funnel, rank is likely to reflect random variation. This contrasts with the common interpretation that rank reflects the quality of care.

We disagree with the interpretation of outliers. Noting that there are zero cases of Staphylococcus aureus bacteraemia (SAB) does not assist in determining whether hospitals are underreporting or are exemplar institutions. Although broad stratification by hospital grouping has been applied to formulate risk groups, both clinical and statistical heterogeneity is evident within each stratum, as we and the National Health Performance Authority have both noted.1-3

Additionally, the identification of “positive deviants” may be useful. For instance, we noted that Flinders Medical Centre had SAB rates below the funnel for both years. Consequently, we contacted its infection prevention unit for advice on how we might reduce infections at our own institution. A more comprehensive approach might be to report SAB rates along with the results of auditing and other relevant findings in outlier hospitals.

Authors

  • Allen C Cheng1,2
  • Leon J Worth2
  • 1. Monash University, Melbourne, VIC.
  • 2. Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, VIC.

Correspondence: allen.cheng@monash.edu

Competing interests

No relevant disclosures.

References

View this article on Wiley Online Library

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