Hospital-Acquired Infections on the Rise in Pennsylvania

Jul. 13–Hospital-acquired infections on rise, report says More than 10,600 Pennsylvania hospital patients developed bacterial or viral infections during their stays in 2004, and 1,793 of them died.

Patients spent 205,000 extra days in the hospital fighting these infections, and racked up $2 billion in additional hospital charges, an independent state agency stated in a new report released today.

“This first snapshot of statewide numbers should be a wake-up call for all parties involved in the delivery and payment of hospital care,” said Marc Volavka, executive director of the Pennsylvania Health Care Cost Containment Council, which published the report.

Hospital-acquired infections are not new, but they are becoming more common. The number of infections nationwide increased by 36 percent between 1975 and 1995 and resulted in 90,000 deaths, reported the New England Journal of Medicine.

Pennsylvania is the first state in the nation to begin collecting and reporting information about hospital-acquired infections.

The true numbers of deaths, hospital days and charges are certainly higher than those reported by PHC4, but many hospitals were reluctant to share their infection data with the agency. Several hospitals submitted invalid infection data, and 16 others, including several large hospitals, reported no infections at all.

“It’s crazy ridiculous that 16 hospitals in the state reported no infections,” said Jim Donnelly, Hamot Medical Center’s chief quality officer. “Every hospital has them.”

The report did not break down the data on a hospital-by-hospital basis, and PHC4 officials would not say which hospitals failed to report their infections. Hamot and Saint Vincent Health Center officials said their hospitals reported all infections.

“Since the council doesn’t feel it’s getting a complete reading on infections, it feels that issuing hospital-by-hospital data would unfairly penalize the hospitals that are cooperating, “said PHC4 spokesman Joe Martin.

Hospital-acquired infections have risen partly due to the type of patients hospitals now treat, said Howard Nadworny, M.D., Saint Vincent’s director of infection control.

Gone are the days when a young person with a broken leg would spend three or four days in the hospital.

“Now you don’t go in unless you’re very sick,” Nadworny said. “These are patients more likely to acquire infections and have the procedures like a ventilator or central IV line than can lead to them.”

That doesn’t mean hospitals aren’t working to reduce their infection cases. Hamot recently purchased a computer system to more accurately track infections throughout the hospital.

MedMined automatically tracks down any positive culture from Hamot’s lab and determines whether the patient’s infection was acquired inside or outside the hospital.

“If you don’t know about the infections, you can’t fix them,” Donnelly said. “Once MedMined was up and running, we had a tenfold increase in the number of identified infections. We already had them, but now we know about all of them.”

It might be more difficult for smaller hospitals to supply PHC4 with infection data.

Collecting the data can take a lot of effort and time, especially if the hospital doesn’t have a system like MedMined, said Hamot epidemiologist Emily McCracken.

“At some of these smaller hospitals, you have one person who is doing hospitalwide surveillance with another job,” she said. “It’s almost impossible to do.”

Meadville Medical Center officials declined to comment on the PHC4 report, except to issue a statement from medical director David McNamara, M.D.

“At MMC we have fully complied with all requirements for reporting imposed by (PHC4),”McNamara wrote. “While our hospital-acquired infection rate at Meadville Medical Center is low, we have several programs in place to improve outcomes.”

Eventually, PHC4 will publish infection data on a hospital-by-hospital basis, which will force hospitals to take an even closer look at their infection rates, Nadworny said.

“It can only be for the better,” Nadworny said. “Some infections are not preventable, but many are. There are opportunities to decrease the infection rates, if you measure them and take the means to avoid them.”

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