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State Watch

Recent State Developments in Public Disclosure of Hospital Infection Rates

Pittsburgh Tribune-Review Editoral

How Many More Pennsylvania Patients Must Die Before Hospitals Come Clean? Click here to read full editorial.

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“Infection rates for individual hospitals should be made available to the public at large, just as access to the National Practitioner Data Bank maintained by the Health Resources and Service Administration should be publicly available.”

                                    "To Err Is Human" co-author Lucian L. Leape, M.D., an adjunct professor at the Harvard School of Public Health, and Commonwealth Fund President

Karen Davis, Ph.D.

 

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The Pennsylvania Department of Health Said It Would Start Fining Hospitals That Fail to Report Hospital Acquired Infections

Click here to read full story.

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Are Our Hospitals Making Us Sick?

Care facilities across the nation should be focused on reducing infections inside their walls. In Texas, one critic says, lawmakers have 'punted' on the problem. So have many others. Click here to read full story.

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More than 11,600 Patients Acquired Hospital Infections in Pa. Last Year

July 13, 2005

Pennsylvania on Wednesday became the first state to publicly report the toll hospital infections take, saying that more than 11,600 patients got infections while in hospitals last year. Those infections led to an additional 1,500 deaths and $2 billion in hospital charges.

"The consequences clearly are huge," says Marc Volavka, executive director of the Pennsylvania Health Care Cost Containment Council, an independent state agency that published the data. "Everyone is paying the bill."

Pennsylvania is one of six states that require hospitals to report information on infections, and it is the first state to publicize its findings. "The deaths associated with those patients and the costs associated with those patients are astounding," said Volavka. "These numbers, even on their own, stand as a clarion cry to take action."

Officials at the council said they suspect the actual incidence of infection is higher because of seeming inconsistencies in the quarterly reports on four types of infections that Pa. hospitals were required to file last year and due to the fact that sixteen facilities, including several large hospitals, reported having no infections at all last year. The actual tally could be as high as 115,000 infections, based on billing claims the hospitals submitted to insurers. Read more on the Pa. infection scourge.

 

N.Y. Lawmakers Expect to Pass Bill Requiring Hospitals to Report Infections to Public
Associated Press
June 15, 2005

ALBANY, N.Y. -- New York state hospitals would be required to publicly report serious infections blamed for 90,000 deaths nationwide each year, under a bill gaining bipartisan support in the Legislature.

The bill, supported by a wide range of health care, business, senior and consumer groups, would require hospitals to track and report various kinds of serious infections and report them to the state Health Department.

After a yearlong pilot program, consumers across the state would be able to access the data online to see how hospitals fared in preventing infections, said Richard Gottfried, chairman of the Assembly Health Committee and a sponsor of the bill.

By being required to report the infection data, hospitals will be able to see how they stack up against competitors and then work to improve their performance. They'll also face the loss of customers who choose to go elsewhere if they don't see a good record in preventing infections, supporters of the bill argued.

"It improves the process to know that other people have figured out how to do something better," said Arthur Levin, director of the Center for Medical Consumers. "Everybody understands that being able to compare yourself to rival institutions moves the quality forward."

Healthcare advocates hope to see the same type of improvement in infection rates as occurred in the mid-1990s after the state started to require hospitals to report the results of cardiac surgeries.

Both houses of the Legislature are expected to vote on the measure next week, Gottfried said.

Republican state Sen. Kemp Hannon, who is sponsoring the bill in his house, said the data will be compiled according to risk factors at the hospitals so comparisons are done fairly. That provision was needed to get the support of the industry, Gottfried said.

Bloodstream, urinary tract and surgical site infections, along with pneumonia, account for most of the infections.

Andrew Rush, a spokesman for Gov. George Pataki, said the state Health Department has been working with lawmakers on the bill. Pataki will review the measure when it passes the Legislature, Rush said.


Commentary

Public Disclosure of Hospital Infection Rates

It's your worst nightmare. You go to the hospital for one problem and get sick from something else -- something potentially much worse -- a so-called "hospital acquired" or "nosocomial" infection.  Moreover, your chances of contracting a nasty, antibiotic-resistant -- and sometimes fatal -- infection is much higher at some area hospitals than at others. Would you want to review your area hospitals' infection rate information before you "checked in" to one of the facilities for an elective procedure? You bet-- but you can't-- because hospitals traditionally have kept this important information secret--from just about everyone!

According to the Centers for Disease Control and Prevention (CDC), 90,000 Americans die each year from hospital infections, and another 1.9 million suffer needlessly from infection related illnesses. Due, in part, to the "healthcare quality" movement which has grown steadily over the last few years, a nationwide battle cry has begun to require hospitals to report infection rates to the public. All we can say is that it's about time!

We believe that mandatory reporting and public disclosure of hospital infection rates will provide consumers with information they can use to make better health-care choices-- information that can literally save lives.

Moreover, publicly reporting infection information will stimulate quality improvement efforts, leading to overall improvements in patient safety. Read more about hospital acquired infections.

 

Mandatory Public Reporting of Hospital Infections Gains Momentum

Efforts to require public disclosure of hospital infection rates have picked up steam in the past year, as states begin to enact such laws and many others consider such statutes in their current legislative agendas.

Four states have adopted infection disclosure laws: In 2002, Illinois became the first state to pass a law requiring hospitals to report the rate at which their patients are developing infections. Since that time, the Pennsylvania Health Care Costs Containment Council approved a plan for infection rate reporting and both Florida and Missouri have adopted disclosure requirements. Pennsylvania is the only state currently collecting the infection reporting information from hospitals and no state has issued a report yet.

Many more states, however, are beginning to follow the lead established by the 4 states discussed above: Lawmakers in 28 states have introduced bills designed to reduce hospital infections, in many cases based on model infection rate disclosure legislation developed by Consumers Union. Hospital infection bills have been introduced in: Alabama, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Indiana, Iowa, Kansas, Kentucky, Maryland, Minnesota, Mississippi, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Vermont, Virginia, Washington, and West Virginia. For more information on each of these state bills, click here.

Responding to the growing interest and activity from lawmakers around the country, the CDC Infection Control and Advisory Committee issued a set of guidelines on February 28 to help states in implementing such reporting laws. The CDC Committee called the guidelines a starting point in the process of public reporting that it intends to update on an on-going basis.

“These guidelines demonstrate that the CDC and infection control specialists recognize the public demand for accountability on hospital acquired infections,” said Lisa McGiffert, of Consumers Union. “Having infection experts involved in a positive way is essential to developing useful reports.” To read the guidelines, click here.

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Many infections could be prevented if hospitals did a better job implementing and adhering to proven infection control practices, like hand washing. Unfortunately, many hospitals have not done so. According to the National Quality Forum, studies have shown that hand washing compliance rates are generally less than 50 percent. Read more. Research by the American Health Quality Association has shown that up to half of all surgical site infections could be avoided with the appropriate use of prophylactic antibiotics. But only 55 percent of a sample of Medicare patients received antibiotics in the recommended time frame prior to surgery, according to a study published in the Archives of Surgery in February 2005. Read abstract.

“Hospital infections are an indicator of other systemic problems, such as inadequate staffing, poor care coordination, or lack of timely patient assessments,” said McGiffert. “Hospitals that do a better job of keeping infection risks low generally score higher on a whole variety of patient safety measures.” To read a policy brief by Consumers Union, click here.

 

GOVERNOR SCHWARZENEGGER VETOES BILL AIMED AT DISCLOSURE OF HOSPITAL ACQUIRED INFECTIONS

Veto Means Hospital Infection Rates Will Stay Secret

SACRAMENTO, CA Thursday, September 30, 2004 – Californians will remain in the dark about whether their local hospital is failing to keep infection risks under control now that Governor Schwarzenegger has vetoed SB 1487. The bill would have required public disclosure of hospital infection rates. Each year thousands of Californians die from infections they pick up in the hospital and many others suffer needlessly from infection-related illnesses.

"Hospital infections are a leading cause of death in the U.S. and yet patients have no way of knowing whether their hospital is doing a good job minimizing such hazards,” said Earl Lui, Senior Staff Attorney with Consumers Union’s West Coast Office. “By vetoing this legislation, Governor Schwarzenegger missed an opportunity to shine the spotlight on this serious public health threat and to make our hospitals safer.”

The CDC says that one in 20 patients get an infection while hospitalized. The California Department of Health Services estimates 7,200 to 9,600 Californians die every year from hospital-acquired infections. Nationally, an estimated 90,000 people die annually from infections contracted in the hospital, according to the Center for Disease Control and Prevention. Another 1.9 million Americans develop these infections and many of them endure longer stays in the hospital getting treated for and recovering from infection-related illnesses.

A single hospital infection incident can add $38,600 to a patient’s hospital bill and as much as $58,000 for one of the most serious infections, postoperative sepsis. Overall, hospital infections add $5 billion to our nation’s health care bill. Studies show that infection rates could be reduced by up to 70 percent if proper procedures, especially hand washing, were followed.

Many hospitals track their own infection rates, but they are not currently required to report this information to any regulatory agency in California. B 1487 would have required hospitals to report to the Office of Statewide Health Planning & Development the rate at which their patients develop infections during treatment and mandated that the agency make this information publicly available. Similar hospital infection reporting requirements recently have been adopted in Illinois, Pennsylvania, Missouri, and Florida.

Several states have established mandatory hospital reporting requirements for such things as the outcome of heart surgeries, which has helped to improve the quality of care that patients receive. Likewise, public reporting

of hospital-acquired infection data will give hospitals a much stronger incentive to reduce the rate of infections.

In his veto message on SB 1487, the Governor indicated that hospitals are already required to have infection control programs in place and that there is sufficient government oversight to make sure that they are enforced. However, some hospitals are failing to make sure that infection control procedures are rigorously followed.For example, the National Quality Forum reports that hand washing compliance rates at hospitals are less than 50 percent.

Moreover, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) has done a poor job of making sure that hospitals follow infection control procedures. The agency accredits hospitals for the federal government and other forms of hospital oversight lean heavily on JCAHO’s accreditation process. JCAHO checks on whether hospitals have infection control practices in place, but not on the rate at which these infections are actually occurring.

Since 1995, JCAHO has “required” hospitals to voluntarily report serious infection injuries or deaths. Over the past nine years, only 42 such reports have been made, even though the CDC estimates that more than 800,000 people died from infections during that period. Further, in a recent study the U.S. Government Accountability Office found that JCAHO failed to detect two-thirds of the serious hospital deficiencies identified through other means.

“Public reporting of infection rates would put pressure on hospitals to do a better job protecting their patients and help consumers select the safest hospitals,” said Imholz. “Unfortunately, Governor Schwarzenegger has given in to the pressure of the politically powerful hospital industry, which lobbied hard for a veto because it wants to keep this information secret.”

 

 

 

 

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Last update on: 6/14/05

 

 

 

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