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Hospital Sloppiness Costing Taxpayers Billions

November 17, 2005

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A health policy group charges taxpayers are being forced to pick up the bill for infections patients pick up while in the hospital. The Pennsylvania Health Care Cost Containment Council says the federal Medicare program and Pennsylvania's Medicaid program were billed for 76 percent of the 11,668 hospital-acquired infections reported by Pennsylvania hospitals in 2004.

According to the report, Medicare and Medicaid were billed for 7,870 and 1,028 hospital-acquired infections, respectively. As a result, taxpayers footed the bill for $1 billion in additional hospital charges for Medicare patients and $372 million in additional hospital charges for Medicaid patients.

"The financial toll of potentially preventable hospital- acquired infections is staggering," said Marc P. Volavka, executive director of PHC4. "Our health care system is hemorrhaging money."

The average charges for Medicare patients with a hospital- acquired infection were about $160,000, compared to $32,000 for Medicare patients who did not contract an infection. For Medicaid patients, the average charges were approximately $391,000 for patients who contracted an infection while hospitalized, compared to an average of $29,700 where an infection did not occur.

PHC4 says private-sector commercial insurers, where the health care bills are paid primarily by businesses and labor unions that provide health insurance, were billed for almost 23 percent -- or 2,633 -- of the reported hospital-acquired infections, which added $604 million in extra hospital charges.

The average charge for a hospital admission in which a commercially insured patient contracted a hospital-acquired infection was almost $258,000, compared to $28,000 for admissions where an infection did not occur. The average charges for a stay in which uninsured patients contracted an infection reached almost $230,000, compared to $21,000 for uninsured patients without an infection.

"Assuming that Pennsylvania hospitals are no better or worse than those anywhere else in the country, we can estimate that at least $20 billion was charged to Medicare to pay for hospital- acquired infections in this country during 2004," said Volavka.

"Given that hospitals underreported the 2004 data, this number is undoubtedly low."

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