Evaluation of hospitalization for infections that are present on admission.

Hospitals have experienced increasing requirements for public reporting of various infection rates using clinical and administrative data. Until recently, such reports have not included analysis of "present on admission" (POA), an indicator designed to assess whether such infections are hospital acquired. The authors evaluated the frequency of the POA coding designation for 167 University HealthSystem Consortium hospitals for sepsis/septicemia (S-S), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile infection (CDI). The authors found that 70% of hospitalizations of patients with S-S, 86% of patients with MRSA, and 67% of patients with CDI had these conditions coded POA. The authors recommend that public reporting of hospital infection rates include POA status and that all health care organizations and providers should work more closely together to identify early and prevent such serious infections.