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Pennsylvania Becomes First State to Publicly Report Number of Patients Who Had Hospital Infections
Hospital-acquired infections last year accounted for 1,793 deaths in Pennsylvania, according to a study released on Tuesday by the... Pennsylvania Health Care Cost Containment Council, the Philadelphia Inquirer reports (Goldstein, Philadelphia Inquirer, 7/13). The study used billing data and reports from hospitals in the state to determine the rate of infections (Connolly, Washington Post, 7/13). Sixteen of the 173 hospitals involved in the study reported no infections (Appleby, USA Today, 7/13). For the study, PHCCCC collected reports on surgical site infections for orthopedic procedures, neurosurgery and cardiovascular surgery, in addition to data on urinary catheter, ventilator and bloodstream infections (Philadelphia Inquirer, 7/13). According to the study, based on billing data, Pennsylvania hospitals reported 11,668 infections in 2004, although the actual number could exceed 115,000 (Rundle, Wall Street Journal, 7/13). The study found that 7.5 of every 1,000 hospital patients developed infections in 2004, but the actual number likely is higher, PHCCCC Executive Director Marc Volavka said (USA Today, 7/13). The mortality rate among hospital patients who developed infections was 15.4% in 2004, compared with 2.4% among other patients, the report found (Fahy/Snowbeck, Pittsburgh Post-Gazette, 7/13). The study found that mortality rates were highest at 32% among Pennsylvania hospital patients who developed pneumonia from the use of a ventilator. Urinary tract infections developed through use of a catheter were the most common infection reported, the study found. The study found that the average cost to treat Pennsylvania hospital patients who developed infections was $29,000 in 2004, compared with $8,300 for those who did not. The infections cost an extra $2 billion in care in Pennsylvania (Washington Post, 7/13). In addition, infections were associated with an additional 205,000 hospital days for Pennsylvania patients, the study found. Based on the results of the study, Volavka estimates that as many as 125 hospital patients die daily from infections nationally, at a cost of $50 billion in hospital bills annually (Wall Street Journal, 7/13).

Results Questioned
According to Carolyn Scanlan, president and CEO of the Hospital & Healthsystem Association of Pennsylvania, the number of infections that the study found through the use of billing data does not account for infections patients had before they entered hospitals (Wall Street Journal, 7/13). In a letter to PHCCCC, Scanlan said the study "implies that all the deaths (and all costs and additional hospital days for patients with reported hospital-acquired infections) were directly related to the hospital-acquired infection" (Philadelphia Inquirer, 7/13). Nancy Foster of the American Hospital Association said, "Hospitals want to share good, reliable information that doesn't overstate or understate the infection problem" (USA Today, 7/13). Volavka said an infectious disease specialist worked with PHCCCC to eliminate infections from the study that patients developed before they entered hospitals. Pennsylvania is the first state to collect data on hospital-acquired infections, as required by a state law enacted last year. Several other states have laws that require hospitals to report data of infections, and 30 more have considered such legislation (Washington Post, 7/13).

Additional Comments
CMS Administrator Mark McClellan said, "The Pennsylvania report is more evidence that there are opportunities to improve quality, reduce cost and, most importantly, save lives through initiatives to reduce hospital infections" (USA Today, 7/13). Volavka said the study indicates "that the cost and quality implications for potentially preventable hospital infections are astounding" (Philadelphia Inquirer, 7/13). He added, "These numbers, even on their own, stand as a clarion cry to take action" (Raffaele, AP/Las Vegas Sun, 7/13). Scanlan said, "The optimal goal would be to get hospital-acquired infections to zero, but nowhere in the literature does anyone indicate how fast or how to get there." Paul O'Neill, former Treasury Secretary and an advocate of health care quality initiatives, said, "This is a day for real celebration that we finally have a major state with a substantial characterization of things that are going wrong in the health and medical care business" (Wall Street Journal, 7/13). The study is available online. Note: You must have Adobe Acrobat Reader to view the study.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.