BILL WOULD MAKE HOSPITALS COME
CLEAN ON INFECTIONS
FACILITIES IN STATE CURRENTLY DON'T HAVE TO DISCLOSE RATES OF PATIENT INFECTION.
James T. Mulder Staff writer
New Yorkers can learn if the restaurants they eat in have been cited for health violations. But they cannot find out if their local hospitals have unacceptably high patient infection rates.
Betsy McCaughey, Gov. George Pataki's former lieutenant governor, finds that preposterous. "You can go home and make your own sandwich," said McCaughey, a health policy expert. "But you can't take care of yourself medically. You have to go to the hospital sometimes and you need information on safe hospitals."
McCaughey is one of a growing chorus of voices calling on New York hospitals to publicly disclose infection rates as a way to save patient lives and cut health care spending.
New York is one of 30 states considering legislation that would make hospitals report how frequently patients contract infections during hospital stays. Hospital infections kill 90,000 Americans annually, according to the federal Centers for Disease Control and Prevention. That's more than the death toll caused by auto accidents and homicides combined. Another 1.9 million people get hospital infections that lead to lengthy rehabilitation, disability and unemployment.
Many of these "bugs" could be avoided if hospitals followed basic infection control strategies, such as hand-washing by health care workers, according to the CDC. Doctors clean their hands before treating patients less than half the time, studies show.
Making infection rates public would goad hospitals to improve, said Bruce Boissonnault, of the Niagara Health Quality Coalition, a Buffalo-area group that publishes a New York State Hospital Report Card designed to help consumers judge the quality of their local hospitals.
"Nothing sanitizes like sunshine," Boissonnault said. "Until the problem is brought to light, it's less likely that it will get the attention and urgency it deserves."
He said recent studies show a high percentage of doctors' neckties and cell phones have infectious bacteria on them. "This is not a mysterious thing that we don't know how to fix," Boissonnault said. "We need the numbers and we need people to follow procedures around scrubbing that have been known for decades."
The CDC and many states, including New York, have been collecting infection data from hospitals for years, but this information is kept secret. "There's been a real code of silence about this issue," said Lisa McGiffert, of Consumers Union, which is leading a national campaign for public disclosure of this information.
McCaughey recently launched a group called the Committee to Reduce Infection Deaths that is also pushing for public infection reporting. In addition to harming patients, infections inflate medical costs, she said. A post-surgical wound infection doubles the hospital cost for a patient, a staph infection triples the cost, and a serious blood stream infection adds about $57,000 on average on top of the cost of treating a patient in an intensive care unit, according to McCaughey.
The nation spends about $28 billion a year treating hospital infections.
At a time when the state is considering closing hospitals to control Medicaid costs, it's overlooking the potential savings that can be gained through lowering hospital infection rates, she said.
Assemblyman Alexander "Pete" Grannis, D-Manhattan, estimates the state could save as much as $200 million a year by reducing hospital infection rates among Medicaid patients. "This hospital-acquired infection seems to be not only an issue that cries out for attention but is an easy way to save money and improve health care," he said.
Since 2002, four states - Illinois, Pennsylvania, Florida and Missouri - have adopted infection disclosure laws. Bills have been introduced in 30 states.
The New York bill, sponsored by Sen. Nicholas A. Spano, R-Westchester, and Assemblyman Adam Bradley, D-Westchester, would make hospitals report infection rates to the state Health Department each quarter. The Health Department would then report the rates to the governor and the Legislature annually. A committee of health care experts would work with the Health Department to set up ground rules for reporting. Once the guidelines are set, hospitals would have a year before they'd have to begin reporting.
The bill says the annual report on hospital infection rates would be available to the public "upon request."
McCaughey sees that as a major flaw in the bill. "When you are dealing with state government, "upon request' could take months," she said.
Boissonnault said patients requiring hospital care need that kind of information quickly. "It should be put on the Internet for every hospital in the state," he said.
Changes may be made to the bill during the committee process to make the information more readily available to the public, said Tony Giambruno, an assistant to Spano. He also said the Health Department could decide to post the information on its Web site.
Dr. Nanette Sable, who's in charge of infection control at St. Joseph's Hospital Health Center in Syracuse, said she's not convinced making the data public would reduce infection rates.
"What I'm worried about is the resources that would be put into collecting rates that are legislated would take away from the resources that we put into what we consider our individual hospitals' problems," she said.
The Healthcare Association of New York State supports public reporting as long as it's done scientifically and reflects the fact that some hospitals treat more higher-risk patients than others, said Matt Cox, spokesman for the Albany-based group that represents hospitals.
"Hospitals have no
interest in taking in sick people and making them sicker," Cox said.
Dennis Nett
/Staff photographer
AMY GRESSLER,of
Liverpool, a registered nurse at St. Joseph's Hospital
Health Center, washes her hands in a patient's room. A proposed state
law would divulge infection rates at hospitals, which cost the nation
about $28 billion annually.
Copyright, 2005, The Herald Company