HAI Calculators Technical Overview – Version 1.0

1. HAI Calculators Technical Overview – Version 1.0 November 2010

2. Technical Overview • Background/ Requirements • HAI Statistical Models • Review of Calculators • Navigation • Inputs • Outputs • References

3. Background/ Requirements • APIC 2005 Model as starting point • Develop New Model using national data (Version 1.0) • Target Six HAIs • SSI • CLABSI • UTI • VAP • MRSA • C-Difficile • Output PPT, Flash and XL Format

4. HAI Statistical Models • Underlying Calculator is a series of regression models • Data source is AHRQ HCUP (NIS) • 2007 Year only • 1044 hospitals from 40 states • 6.6M discharges • Adults 18 and Older • Infections • 6 HAIs - ICD-9 Codes • No POA flags in 2007 Data

5. Definitions of Infections and Populations

6. HAI Statistical Models • SSI Identification • Follow de Lissovoy et al. Methodology • Secondary ICD-9 Code 998.59 • Analysis limited to Surgical DRG • VAP Identification • Secondary ICD-9 Code 997.31 (VAP) • Analysis limited to patients with use of ventilator (96.70, 96,71, and 96.72) • UTI Identification • No billing codes for use of urinary catheter • Refer to Table for ICD-9 codes • Limited analysis to Surgical DRG patients

7. HAI Statistical Models • CRBSI Identification • AHRQ Patient Safety Indicators • Secondary ICD-9 Code 999.31 • All Patients with Surgical DRG • Patients with Principal ICD-9 999.31, 999.2, and 999.62 excluded • Immunocompromised and Cancer Patients excluded • MRSA Identification • Secondary ICD-9 Code 41.12 • All Patients

8. HAI Statistical Models • C-Difficile Identification • Secondary ICD-9 Code 8.45 • Only indicates Presence • All Patients Medical and Surgical • Regression Models • Linear regression models for estimates of Excess Cost and LOS for each Class of Hospitals • Separate regression for each class for region, setting, teaching status and size • Hospital Size defined using AHRQ criteria

9. Hospital Size Definition

10. Review of Calculators • Calculator Format • Excel with Macros • Online Flash Version • PPT with embedded • CareFusion 1.0 – XL and Flash

11. CareFusion Excel - Version 1.0

16. CareFusion PPT - Version 1.0