Catheter-associated urinary tract infection and the Medicare rule changes

Ann Intern Med. 2009 Jun 16;150(12):877-84. doi: 10.7326/0003-4819-150-12-200906160-00013.


Catheter-associated urinary tract infection, a common and potentially preventable complication of hospitalization, is 1 of the hospital-acquired complications chosen by the Centers for Medicare & Medicaid Services (CMS) for which hospitals no longer receive additional payment. To help readers understand the potential consequences of the recent CMS rule changes, the authors examine the preventability of catheter-associated infection, review the CMS rule changes regarding catheter-associated urinary tract infection, offer an assessment of the possible consequences of these changes, and provide guidance for hospital-based administrators and clinicians. Although the CMS rule changes related to catheter-associated urinary tract infection are controversial, they may do more good than harm, because hospitals are likely to redouble their efforts to prevent catheter-associated urinary tract infection, which may minimize unnecessary placement of indwelling catheters and facilitate prompt removal. However, even if forcing hospitals to increase efforts to prevent complications stemming from hospital-acquired infection is commendable, these efforts will have opportunity costs and may have unintended consequences. Therefore, how hospitals and physicians respond to the CMS rule changes must be monitored closely.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Catheter-Related Infections / economics*
  • Catheter-Related Infections / prevention & control
  • Catheters, Indwelling / adverse effects*
  • Catheters, Indwelling / economics
  • Hospital Costs*
  • Humans
  • Medicare / economics*
  • Relative Value Scales
  • United States
  • Urinary Catheterization / adverse effects*
  • Urinary Catheterization / economics
  • Urinary Tract Infections / economics*
  • Urinary Tract Infections / etiology
  • Urinary Tract Infections / prevention & control