Table 1.
Frequency of Urine Cultures and Fluoroquinolone Use Before and After the Centers for Medicare & Medicaid Services Stopped Reimbursing Hospitals for Treatment of Hospital-Acquired Catheter-Associated Urinary Tract Infection
| Outcome (No. of Hospitals) | Prepolicy Period (1 June 2007–30 September 2008) |
Postpolicy Period (1 October 2008–28 February 2010) |
|||
|---|---|---|---|---|---|
| Median Frequencya (95% CI) | Relative Change,b % (95% CI) | Median Frequencya (95% CI) | Relative Change,b % (95% CI) | Pc | |
| Urine cultures (n=35) | 180 (150–216) | 0.50 (0.40–0.59) | 185 (154–222) | −0.25 (−0.34 to −0.17) | <.001 |
| Wound cultures (control variable; n = 28) | 27.0 (20.9–34.9) | 0.60 (0.32–0.88) | 26.2 (20.3–33.9) | −0.83 (−1.11 to −0.58) | <.001 |
| FQ use in all admissions (n = 10) | 128 (92–177) | 0.30 (0.10–0.50) | 123 (89–171) | −1.24 (−3.08 to −0.59) | <.001 |
| FQ use in patients with a urine culture at time of admission (n = 10) | 272 (158–468) | 1.28 (0.98–1.58) | 267 (155–458) | −0.47 (−0.74 to −0.19) | <.001 |
Abbreviations: CI, confidence interval; FQ, fluoroquinolone.
a Defined as the No. of cultures or No. of FQ prescriptions per 1000 admissions, from Poisson mixed-effects regression.
b Defined as the slope, expressed as a relative change in frequency of cultures or FQ prescriptions since the previous month, from Poisson mixed-effects segmented regression.
c For comparison of the relative change in frequency (ie, slopes) during the prepolicy and postpolicy periods.