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Hospital infections

There’s something missing from this story. Do you know what it is?

The most common hospital-contracted malady among older patients in Houston is systemic vascular infections, a problem often caused by unsanitary or improper procedures during their hospital stay, a new study of Medicare claims shows.

Among 46 hospitals within a 50-mile radius of the city of Houston, half reported vascular infections in Medicare patients through catheters, the tubing used for various procedures.

A total of 472 “hospital-acquired conditions” were reported from the 234,200 Medicare discharges from October 2008 through June 2010. That’s two incidents per 1,000 Medicare discharges in Houston.

Allowing the public to see information about mishaps and errors that occur during a patient’s hospital stay has been a contentious issue for hospital personnel, who believe the public could misread it. To date, there’s no universal ranking system for the public to determine the safety of the nation’s hospitals.

The reports released this month by the Centers for Medicare and Medicaid Services is the first to look strictly at how many times bedsores, surgical errors and falls and trauma, for example, occur among Medicare patients.

“We wanted to bring transparency to the fact that patients are exposed to potentially unsafe occurrences at America’s hospitals, said Donald McLeod, a spokesman for the U.S. Department of Health and Human Services. “We hope that by making the data public, we will spur hospitals to work with care providers to reduce — or even eliminate – these hospital-acquired conditions from happening again to even a single patient.”

Have you figured it out yet? Here’s the answer:

Health and Human Services Secretary Kathleen Sebelius on Tuesday pledged “up to $1 billion” for a new “Partnership for Patients.” The initiative aims to reduce preventable hospital infections and patient readmissions after they have been discharged.

“Every time a patient gets an infection in the hospital, or is readmitted because they didn’t get the right follow-up care, our nation’s health care bill goes up,” Sebelius said at a news conference at the National Press Club in Washington, D.C.

The proposal builds on existing rules for Medicare hospital payments, which impose financial penalties against hospitals for patients who experience preventable complications. Among the types of complications hospitals will be asked to examine are those associated with adverse drug reactions, bed sores, childbirth and surgical site infections.

The billion dollars is to come from the Affordable Care Act, last year’s health overhaul. According to HHS, if health care professionals are successful in reaching the goals laid out in the initiative, the initial $1 billion investment could reap as much as $35 billion in savings over the next three years, including $10 billion for Medicare alone.

“As the country’s largest payer for care, Medicare has a powerful ability to be a catalyst for change,” said Sebelius.

Yes, what’s missing from this story is any mention of the Affordable Care Act. One provision of the ACA that went into effect this January was that hospitals will now have to track and report to the Centers for Disease Control and Prevention’s National Healthcare Safety Network when patients get central line associated bloodstream infections (CLABSIs) in intensive care units. The point of this is partly to make this information more transparent to the public, and partly to reduce the incidence and cost of these infections, which represent a huge amount of money being spent and which can be prevented by such simple practices as better hand-washing and more care with catheters. I don’t know why the Affordable Care Act and the role it is playing in reducing hospital-acquired infections and their associated costs weren’t mentioned in this story, but now at least you know they should have been.

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2 Comments

  1. Peter Wang says:

    My take away message – do everything you can to manage your own health so you don’t get sick or injured, because hospitals can kill you.

  2. texaschick says:

    Peter,

    Manage your own health is great but there are things that happen in life for which you have no control over whatsoever.

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