Yet another method for measuring inpatient care quality is to consider the number of nosocomial or iatrogenic illnesses at that facility. An iatrogenic condition is one that is caused by medical examination or treatment, while a nosocomial illness refers to an illness (usually an infection) originating at a hospital. Often, nosocomial infections are resistant to multiple antibiotics and are quite difficult to treat.

Under the HACRP, which started in 2014, hospitals are penalized 1% of their total Medicare payments if their patients are at a high risk of getting hospital-acquired infections. More specifically, hospitals that meet a certain score threshold based on how often their patients get five common healthcare-acquired infections and their AHRQ Patient Safety Indicator (PSI) 90 composite measure performance are eligible for a 1% reduction in Medicare reimbursement.

There are six measures comprising the HAC program that span two domains of care. Five of the six measures relate to infection rates for patients at hospitals. The sixth measure is a composite measure that looks at a variety of adverse patient safety events.

We will now take a more detailed look at the domains and measures.