Infection
Prevention Increases Profits
By Betsy McCaughey
Published January 30, 2006
Westchester residents, like most Americans,
are paying with their pocketbooks and their lives for poor hygiene in their
hospitals.
Infections
that have been nearly eradicated elsewhere are raging through the county
hospitals. One out of every 20 patients contracts an infection in the hospital.
The danger is worsening because, increasingly, these infections cannot be cured
with commonly used antibiotics. In 1974, 2 percent of staphylococcus aureus infections were methicillin
resistant (or MRSA). By 2003, that figure had soared
to an alarming 57 percent, and is still rising.
Denmark, Holland and Finland once faced similar rates but
brought them down below 1 percent. How? Rigorous hand hygiene, meticulous
cleaning of equipment and rooms in between patient use, testing incoming
patients to identify those carrying MRSA and other
bacteria, and taking precautions to prevent the spread of these bacteria from
positive patients to others on gloves, hands, clothing, equipment and
furniture.
A few
hospitals in the United States are proving these precautions
work here too. The University of Virginia Hospital, the Veterans Hospital in
Pittsburgh, the University of Pittsburgh Medical Center-Presbyterian Hospital
and a coalition of 29 health-care institutions in Iowa have reduced
drug-resistant infections by 85 percent or more in pilot programs. Why not
hospitals in Westchester County?
Can
hospitals in Westchester afford to take these more
rigorous precautions? They can't afford not to.
IMPACTING HOSPITAL REVENUE
Infections
erode hospital profits because rarely are hospitals paid fully for the added
weeks or months of care when patients get infections. For example, Pennsylvania's Allegheny Hospital would have made a profit treating
a 37-year-old video programmer and father of four who was admitted with acute pancreatitis, but the economics changed when the patient
developed a MRSA bloodstream infection. He had to
stay in the hospital 86 days, and the hospital lost $41,913, according to
research by Dr. Richard Shannon, chairman of the department of medicine at
Allegheny. Similarly, a woman came into the hospital for stomach reduction
surgery, a procedure that should have produced a $9,900 gross profit for the
hospital. But when she developed a central-line-associated bloodstream
infection and had to spend 47 days in the hospital, that
profit turned into a $16,000 loss. Allegheny reduced central-line-associated
bloodstream infections by 90 percent and death from them by 95 percent, saving
Allegheny $1.4 million the first year.
Hospital
infections add more than $30 billion a year annually to the nation's hospital
costs alone. Where does that figure come from? Two million infections a year
times $15,000 average additional hospital costs for treating the infection.
If cost
is not enough to motivate hospital executives and board members in Westchester to reduce infections, they now
face three other pressures. The first is from the trial lawyers. Remember
asbestos? Hospital infection is the next asbestos. The infection problem has
all the hot-button essentials of a successful class-action lawsuit: 2 million
helpless victims a year, copious evidence that infections are preventable and a
consistent pattern of failure to act.
The
second pressure is public disclosure. In July, New York became the sixth state to enact a
law providing the public with risk-adjusted hospital infection report cards.
The Committee to Reduce Infection Deaths (RID) worked hard to get that law
passed. Why? Because when you have to be hospitalized, you should be able to
find out which hospital in your area has the worst infection problem so you can
stay away.
Finally,
shoddy infection control is poor preparation for an avian flu epidemic and poor
homeland security. How can hospitals that lack the discipline and staff
training to stop ordinary bacterial infections from spreading patient to
patient by touch possibly contain avian flu, which can be spread by touch but
also by droplets when patients sneeze or cough? How could these hospitals
contain a bioterrorism pathogen such as smallpox,
which can spread invisibly in the air?
One of
the best steps hospitals in Westchester can take to prepare for these possible
crises is to improve day-to-day infection control by adopting the more rigorous
precautions advocated by the Committee to Reduce Infection Deaths and described
in a new report: Unnecessary Deaths: the Human and Financial Costs of Hospital
Infection (available at www.hospitalinfection.org).
Improving
hospital hygiene saves lives. It will also help save hospitals from financial
failure, reduce health-care spending, avert costly litigation and improve
preparedness. It's time for Westchester's hospitals to take the lead in preventing
hospital infections. The people of Westchester deserve no less.
Every day
you hear about health problems such as the uninsured. The Institute of Medicine estimated that as many as 18,000
people may die prematurely because they don't have health insurance. But
consider this even more tragic fact. Five times that many people die each year
from hospital infections and most of them are insured. Having insurance is no
guarantee that you will be safe in the hospital. That's why I founded RID -- to
help clean up this deadly problem.
Betsy
McCaughey is chairman of Committee to Reduce Infection Deaths. She is a former
lieutenant governor of New York state.