The Importance of Hospital Infection Report Cards
A Brooklyn woman wishes she had known more when she took her 63-year old mother to the hospital. Johanna had slipped and broken her shoulder at a restaurant, and no one expected that she would be in the hospital for more than a day or two. But a Staph infection ravaged her body for four months and killed her. “What happened to my mother shouldn’t happen to anyone,” said her daughter. “If only I had had enough information to choose a hospital with a better infection record.”
If you need to be hospitalized, wouldn’t you want to know which hospital in your area has the lowest infection rate?
The good news is that twenty-eight states have passed laws to provide the public with hospital infection report cards. Publicly comparing hospital performance will motivate hospitals to improve.
New York’s experience with another type of hospital report card proves this. In 1989, New York became the first state to publish each hospital’s risk-adjusted mortality rate for cardiac bypass surgery. The results? Deaths from bypass surgery dropped 40 percent, giving New York the lowest mortality rate in the nation for that procedure. Critics of hospital report cards speculate that deaths went down in New York because hospitals avoided treating the sickest patients, fearing that high-risk operations would bring down the hospital’s grade. However, the evidence proves that’s untrue. Deaths declined for a different reason: hospitals forced their worst-performing surgeons — generally, those with low volume — to stop doing the procedure. Patients of the 27 barred surgeons were more than three times as likely to die during surgery. In technical jargon, the 27 surgeons had an average risk-adjusted mortality rate of 11.9 percent, compared with a statewide average of 3.1 percent. Wisconsin also found that report cards motivate poorly performing hospitals to improve, according to a 2001 study of 24 hospitals there.
In addition to state reporting, Medicare now provides comparative information on its Hospital Compare website (http://www.medicare.gov/hospitalcompare/search.html). You'll find step-by-step information on how to use that site HERE.
Though almost half the states still do not provide consumers with infection rates by hospital, we at RID encourage them to start. In fact, RID has provided a model bill HERE. This model improves on what most states have done in at least three ways: First, it specifies the method of risk-adjustment for surgical site infections used by the CDC, rather than leaving the risk-adjustment method to be determined by committee. This should assure hospitals that comparisons will be fair and take into account which hospitals treat especially sick and infection-prone patients.
Secondly, the bill imposes civil penalties on hospitals that fail to report or flagrantly underreport their infections. These penalties are needed. For many years, some hospitals have openly ignored data collection laws with impunity. For example, in one recent year, hospitals in New York reported only 16.5 percent of the post-surgical deaths that the law required them to report. In the first year of Pennsylvania’s hospital infection reporting program, hospitals reported only one tenth as many infections to the new program as they billed. Some Pennsylvania hospitals implausibly claimed they had no infections at all.
Thirdly, the model bill ensures that hospital infection reporting will benefit the public, not enrich trial lawyers. The bill provides that “none of the data collected and reported under this law can be used in litigation against an individual hospital.”
Next time you hear an ad on the radio urging you to use a particular hospital because it has the best doctors or the latest equipment, keep in mind what you’re not being told: how many patients get infections while in that hospital. Americans deserve that information. The legislation proposed here won’t help hospitals save face, but it will help you choose a safe hospital. Let hospitals vie for your business by improving their infection rates.
Copyright (c) 2004-2014 The Committee to Reduce Infection Deaths.
All rights reserved. Medical Disclaimer