Hospitals try to slow progress of infections report card
plan Monday, February 09, 2004
By Christopher Snowbeck, Pittsburgh Post-Gazette
Pennsylvania hospitals are trying to slow efforts by a state
agency to generate a statewide report card on hospital-
acquired infections, a decades-old problem that causes many
deaths and illnesses.
The Pennsylvania Health Care Cost Containment Council
notified hospitals in November that it would begin
collecting information on infections this year.
But the Hospital & Healthsystem Association of
Pennsylvania, while pledging support for the idea of a
report card, has argued the data-collection method proposed
by the council has problems. Hospital officials made their
case at a hearing before the council this week in
Harrisburg, and the council has until Feb. 18 to respond to
the hospitals' protest.
"Our discussions with [the council] are not about reporting
or not reporting -- they are about including infection
control experts in the process and refining the data
collection so that the resulting reports will be of high
quality," said Roger Baumgarten, spokesman for the hospital
association. "Reporting is the right thing to do, but it
must be done right."
The Centers for Disease Control and Prevention estimates
that 2 million patients per year suffer infections in
hospitals. Those infections are implicated in 88,000 deaths
per year at a cost of more than $4.5 billion.
Infections were among the issues highlighted in a ground-
breaking 1999 report from the federal Institute of Medicine,
which called for action to reduce medical errors.
The clash between the council and hospitals over infection
reporting comes six months after the groups fought over a
state law that authorizes the council to collect data on
hospitals, doctors and health plans.
In that earlier battle, hospitals asked legislators to
change the council's data requirements because reporting
was too costly. Supporters of the council countered that
hospitals were actually trying to weaken -- if not kill
-- the council and its report cards on health care
quality and cost.
The council survived, but the Legislature's final
reauthorization bill included changes in the reporting
requirements.
While the debate on infection reporting continues in
Harrisburg, the private, nonprofit Pittsburgh Regional
Healthcare Initiative is reporting continued improvements in
its project to reduce bloodstream infections in hospitals.
Nationwide, those infections account for 50,000 of the 2
million hospital-acquired infections each year.
[That's 50,000 (2%) of 2,000,000, Steve. Certainly not
significant.]
When the local project began in 2001, 28 participating
hospitals in the region reported a rate of 4.2
bloodstream infections per 1,000 days that patients used
central-line catheters. The rate dropped to 2.4 per 1,000
line-days for 23 hospitals that reported data in the
third quarter of 2003.
Allegheny General Hospital, in particular, reported
dramatic success in its coronary and medical intensive care
units, where it reported no bloodstream infections in
September 2003.
The catheters are inserted in the chest, neck or groin to
deliver medicines, fluids, blood products or nutrition.
Doctors and nurses can reduce the chance of infection by
following certain practices when inserting and caring for
central lines.
Bloodstream infections kill 14 percent to 40 percent of
those who contract them.
Fatal or not, each one extends a patient's hospital stay by
an average of one week. Those hospitalizations have an
average cost of $33,000.
(Christopher Snowbeck can be reached at csnowbeck@post-
gazette.com or 412 263-2625.)
