Hospital Acquired Infection

Nevertheless, the PHC4 report "suggests hospital-acquired infections add billions of dollars each year to the nation's actual cost of health care," the Inquirer reports. PHC4 Executive Director Marc Volavka said, "The financial toll of potentially preventable hospital-acquired infections is staggering."

Carolyn Scanlan, president and CEO of the Hospital and Healthsystem Association of Pennsylvania, said, "Hospitals recognize the importance of this challenging topic and have significant efforts under way throughout Pennsylvania focused on identification, reduction and prevention of infections" (Goldstein, Philadelphia Inquirer, 11/17).

Pennsylvania was the first state to collect data on hospital-acquired infections. Pennsylvania put hard numbers on a troubling phenomenon that until now has only been estimated. Even so, the infection rate and cost is probably much higher because of underreporting by most, if not all, hospitals. The actual cost could be as high as 115,000 infections, based on billing claims hospitals have submitted to insurers. However, 12,000 contracted infections during hospitals stays in 2004 were substantiated costing an extra $2 billion in care and at least 15,000 preventable deaths. There are known solutions that are not implemented.

Pennsylvania is four percent of the US population which means there may be an additional 100 people dying per day nationwide because of hospital-acquired infections. That comes to an additional $50 billion in medical charges in the US annually. Pennsylvania began last year to require every acute care hospital to report the number of infections contracted in the hospital in four major categories: surgical, bloodstream, pneumonia and urinary tract.

The average cost to treat a Pennsylvania hospital patient who developed an infection was $29,000, compared to $8,300 for those patients who did not. Each quarter, the number of reported infections went up and that trend will continue in 2005 as more and more hospitals realize they need to come into compliance in the State.

Ventilator-associated pneumonia cases at Virginia Mason Medical Center were reduced through simple steps such as keeping the patient's head elevated and insuring the patient breathes independently for at least a few minutes each day. Experts in the field say the simplest remedy for reducing infection is hand washing. Several other States, including Virginia, have passed laws requiring similar reporting by hospitals.

Hospital-acquired infections kill as many patients as AIDS, breast cancer and automobile accidents combined. Many infections can no longer be cured with common antibiotics.

One infection is called M.R.S.A. Patients who do survive M.R.S.A. often spend months in the hospital and endure several operations to cut out infected tissue. In 1974, two percent of staph infections were from M.R.S.A. BY 1995. that figure had soared to 22 percent . Today, experts estimate that more than 60 percent of staph infections are M.R.S.A. The Veteran's Hospital in Pittsburgh, PA, reduced M.R.S.A. 85 percent and the University of Virginia Medical Center eradicated it. Nearly three-quarters of patients' rooms are contaminated with M.R.S.A. Most hospitals in the US don't routinely test patients for staph bacteria. Studies show that 70 to 90 percent of patients carrying M.R.S.A. are never identified.

Many hospital administrators say they can't afford to take the necessary precautions, but they can't afford not to. Infections erode hospital profits because rarely are hospitals fully paid for the added weeks or months that patients must spend in the hospital when they get an infection. Studies show that when hospitals invest in these proven precautions, they are rewarded with as much as a tenfold financial return. These infections add about $30 billion annually to the nation's health costs. This will increase rapidly as more infections become drug-resistant.

Blood infections from central IV lines installed into veins near the heart kill as many as 28,000 patients a year. Installing a central line is a tricky procedure that is often done by inexperienced residents. At Johns Hopkins Hospital when they took aggressive steps to control the dangers of this procedure, including giving nurses permission to halt a central line insertion if they see a doctor doing it wrong, rates of catheter infections dropped to nearly zero.

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