HOSPITAL-ACQUIRED INFECTIONS IN THE UNITED-STATES - THE IMPORTANCE OFINTERHOSPITAL COMPARISONS

To use infection rates as a basis for measuring quality of care, the r ates must be meaningful for interhospital comparison. A crude, overall nosocomial infection rate of a hospital provides no means of adjustme nt for patients' intrinsic or extrinsic risks. Before interhospital co mparison, rates should be adjusted for nosocomial infection risk facto rs. Interhospital comparison of rates requires that a hospital partici pate in a multicenter surveillance system or aggregated national datab ase. This article outlines a series of questions for hospital administ rations to pose before entering such an endeavor.