Hospital‐Acquired Pressure Ulcers: Results from the National Medicare Patient Safety Monitoring System Study

Objectives: To determine the national and state incidence levels of newly hospital-acquired pressure ulcers (PUs) in Medicare beneficiaries and to describe the clinical and demographic characteristics and outcomes of these individuals. Design: Retrospective secondary analysis of the national Medicare Patient Safety Monitoring System (MPSMS) database. Setting: Medicare-eligible hospitals across the United States and select territories. Participants: Fifty-one thousand eight hundred forty-two randomly selected hospitalized fee-for-service Medicare beneficiaries discharged from the hospital between January 1, 2006, and December 31, 2007. Measurements: Data were abstracted from the MPSMS, which collects information on multiple hospital adverse events. Results: Of the 51,842 individuals in the MPSMS 2006/07 sample, 2,313 (4.5%) developed at least one new PU during their hospitalization. The mortality risk�adjusted odds ratios were 2.81 (95% confidence interval (CI) = 2.44�3.23) for in-hospital mortality, 1.69 (95% CI = 1.61�1.77) for mortality within 30 days after discharge, and 1.33 (95% CI = 1.23�1.45) for readmission within 30 days. The hospital risk�adjusted main length of stay was 4.8 days (95% CI = 4.7�5.0 days) for individuals who did not develop PUs and 11.2 days (95% CI = 10.19�11.4) for those with hospital-acquired PUs (P < .001). The Northeast region and Missouri had the highest incidence rates (4.6% and 5.9%, respectively). Conclusion: Individuals who developed PUs were more likely to die during the hospital stay, have generally longer hospital lengths of stay, and be readmitted within 30 days after discharge.