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States Take Aim at Hospital Infections

March 9, 2005

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Lawmakers in 28 states are considering bills designed to curb hospital infections, a leading cause of death in the United States. The proposed laws would require hospitals to report their infection rates so consumers can find out if their local hospital is doing a good job keeping patients safe.

"Far too many patients suffer from preventable infections they get while being treated at the hospital," said Lisa McGiffert, director of Consumers Union's Stop Hospital Infection Project. "Informing the public about infection rates will put pressure on hospitals to do a better job of minimizing infections, thus reducing unnecessary illness and keeping patients safer."

According to the Centers for Disease Control and Prevention, 90,000 Americans die each year from hospital infections, and another 1.9 million suffer needlessly from infection related illnesses.

Depending on the type of infection, these patients spend up to 30 more days in the hospital getting treated. These additional treatments and extra days in the hospital add a considerable amount to the nation's health care bill -- as much as $5 billion annually.

Efforts to require public disclosure of hospital infection rates have picked up steam in the past year, as states begin to enact such laws and many others consider such statutes.

Four states have adopted infection disclosure laws

In 2002, Illinois became the first state to pass a law requiring hospitals to report the rate at which their patients are developing infections.

Since that time, the Pennsylvania Health Care Costs Containment Council approved a plan for infection rate reporting and both Florida and Missouri have adopted disclosure requirements. Pennsylvania is the only state currently collecting the infection reporting information from hospitals and no state has issued a report yet.

28 states are considering infection bills: Many more states are beginning to follow the lead established by the above states. Lawmakers in 28 states have introduced bills designed to reduce hospital infections, in many cases based on model infection rate disclosure legislation developed by Consumers Union.

Hospital infection disclosure bills have been introduced in: Alabama, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Indiana, Iowa, Kansas, Kentucky, Maryland, Minnesota, Mississippi, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Vermont, Virginia, Washington, and West Virginia.

CDC Issues Guidelines

Responding to the growing interest and activity from lawmakers around the country, the CDC Infection Control and Advisory Committee issued a set of guidelines on February 28 to help states in implementing such reporting laws. The CDC Committee called the guidelines a starting point in the process of public reporting that it intends to update in the future.

"These guidelines demonstrate that the CDC and infection control specialists recognize the public demand for accountability on hospital acquired infections," said McGiffert. "Having infection experts involved in a positive way is essential to developing useful reports."

Many infections could be prevented if hospitals did a better job implementing and adhering to proven infection control practices, like hand washing. Unfortunately, many hospitals have not done so.

According to the National Quality Forum, studies have shown that hand washing compliance rates are generally less than 50 percent. Research by the American Health Quality Association has shown that up to half of all surgical site infections could be avoided with the appropriate use of prophylactic antibiotics. But only 55 percent of a sample of Medicare patients received antibiotics in the recommended time frame prior to surgery, according to a study published in the Archives of Surgery in February 2005.

"Hospital infections are an indicator of other systemic problems, such as inadequate staffing, poor care coordination, or lack of timely patient assessments," said McGiffert. "Hospitals that do a better job of keeping infection risks low generally score higher on a whole variety of patient safety measures."

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