Plague of Errors

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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