Plague of Errors

Can the states put a stop to 90,000 deaths caused by infection each year?

| November 17, 2005

Hospital-acquired infections kill more people than breast cancer or car accidents, and its rate in patients has shot up 36 percent since 1975. Some concerned states are pushing for more public accountability and better tracking of such infections, which they say could lead to improved practices that save lives. But, as John Buntin reports in Governing, the proposals have ruffled feathers in the medical establishment, a sphere largely regulated from the inside by professional associations and nonprofits.

Legislation being considered in 32 states would encroach on that authority by requiring hospitals to report infections to state authorities. Six states, including Pennsylvania, already have such legislation in place in the hope that public reports will force hospitals to improve their methods.

Leading the charge for hospital accountability is the Pennsylvania Health Care Cost Containment Council (PHC4). Under a recent change in leadership, the council sifted through a graveyard of billing and administrative data and came up with some troubling figures. According to Buntin, PHC4 documents show that though the some 180 acute-care hospitals in Pennsylvania reported 12,000 of the infections in the categories examined by the council, 120,000 cases of 'what looked like episodes of infection' were billed to insurers. What's more, 20 of those hospitals accounted for 55 percent of the reported infections, and population distribution did not play a significant role.

PHC4's calls for public accountability for failing hospitals have met with some skepticism. Critics argue that trumpeting failure debilitates physicians' access to learning environments safe from litigation. As Buntin points out, the important question for states is, 'What public policy approach will do the most to save lives?'
-- Tyler Otis



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