Hospitals may be hazardous to health

Originally published on April 7, 2005

Under pressure from regulators and watchdogs, hospitals are disclosing more information about the quality of care they provide. A diligent consumer with an Internet connection can look up what percentage of a hospital's patients die during heart surgery, deliver their babies by Caesarean section or receive the right drugs for pneumonia.

But hospitals have yet to come clean about a dirty secret: how many of their patients contract an infection while hospitalized. More often than most people realize, hospitals are breeding grounds for virulent, antibiotic-resistant bacteria.

A conservative estimate from the Centers for Disease Control and Prevention suggests that one out of every 20 patients picks up a bug he didn't have when he checked in. Almost 2 million a year become seriously ill, and 90,000 more die - which is greater than the death toll from car accidents and breast cancer combined.

Experts say most of this suffering - and untold billions worth of extra care - could be avoided if doctors and nurses practiced better hygiene. Yet surveys indicate that hospital employees wash their hands only about half as often as recommended.

Some hospitals are getting tough on hygiene. They're enforcing hand-washing rules, sanitizing equipment more thoroughly, restricting germ-hosting jewelry, using disposable aprons during certain tasks and screening nonemergency patients for bacteria. But there's no way for the average consumer to find out which hospitals have cleaned up their acts. Some voluntarily report infection rates to accreditation agencies and government watchdogs, but many do not.

Consumer organizations such as the AARP and the Consumers Union have pushed four states to require public reporting of hospital infection rates, and now they're lobbying Albany to do the same. Today, former Lt. Gov. Betsy McCaughey, who has became an outspoken advocate on this issue, will return to the Capitol to press for action by the Legislature.

The Greater New York Hospital Association says it supports the concept of infection reporting, as long as the state Health Department takes pains to collect and report data fairly and accurately. There's little question that passing such a law would have a huge impact on public health. Even if consumers didn't look at the figures, every hospital CEO in the state certainly would. And you can bet that institutions with high infection rates would bring them down.

The Health Department should understand this principle better than most. Since 1992, when it began publishing hospital-by-hospital results of cardiac surgery, the mortality rate has fallen 18%, saving dozens of lives a year. As they say, sunshine is the best disinfectant.