The Hospital Infections Disclosure Act (HIDA), passed by the South Carolina General Assembly in May 2006, requires hospitals to report specific types of healthcare-associated infections (HAIs) to DPH. DPH must then compile and analyze the data to provide a final, validated report to the General Assembly by April 15 of each year. DPH then publishes that report to its website. Data from acute care hospitals (ACH), inpatient rehabilitation facilities (IRF), long-term acute care hospitals (LTACH) and critical access hospitals (CAH), are reported annually, and include required reporting of surgical site infections (SSI), central line-associated blood stream infections (CLABSI), Clostridiodes difficile infection (CDI) LabID events, Methicillin-resistant Staphylococcus aureus (MRSA) Bacteremia LabID events, catheter-associated urinary tract infections (CAUTI), ventilator-associated events (VAE), and pediatric ventilator-associated events (PedVAE). SSI data is not all inclusive as it only includes those required for reporting per HIDA. CAUTI, VAE, and PedVAE are not published in the annual HIDA report.
2022 HIDA Report
Since 2016, South Carolina has successfully reported standardized infection ratios (SIR) less than 1.0 for CLABSI and CDI Lab ID events, seen in Figure 1. Surgical site infection (SSI) SIRs have been trending downward since 2020, and in 2022 the SIR decreased to 0.87. Although the MRSA Bacteremia LabID SIR is above the national baseline at 1.08 in 2022, this is a drastic decrease from 1.46 in 2021. DPH and the HIDA Committee remain committed to making strides to reach these established goals, supporting our hospital partners by providing support and resources to improve the health of South Carolinians and provide better and more timely access to care.
In 10-year cycles, the U. S. Department of Health and Human Services (DHHS) publishes national SIR Reduction Target goals (Table 1), which prioritize addressing emerging health concerns, promoting equity in healthcare, and improving well-being. The Healthy People 2030 goal of reducing healthcare-associated infections is centered around SIR target reductions for CDI and MRSA Bacteremia LabID Events.
Table 1. National SIR Reduction Targets for 2020 and 2030
| Measure | 2020 Target Reduction / Target SIR | 2030 Target Reduction / Target SIR |
|---|---|---|
| CLABSI | 50% / 0.50 | Removed |
| SSI | 30% / 0.70 | Removed |
| Hospital-onset CDI | 30% / 0.70 | 30% / 0.70 |
| Hospital-onset MRSA | 50% / 0.50 | 50% / 0.50 |
The 2022 SIRs for HAI event types required for reporting by HIDA are presented in Figure 2 and stratified by facility type. The dotted line represents the baseline result of an SIR equal to 1.0, where the number of observed HAIs equals what was predicted. ACHs reported an SIR of 1.08 for MRSA Bacteremia LabID events, whereas IRFs and LTACHs reported SIRs of 0.32 and 0.25, respectively. The majority of HAI event types reflected an SIR less than 1.0, excluding MRSA Bacteremia LabID events within ACHs, indicating that fewer events occurred than were expected which infers that overall patient care improved.
