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State Hospital Group Disputes Infection Data

Posted on: Wednesday, 29 March 2006, 00:00 CST

By David Wenner, The Patriot-News, Harrisburg, Pa.

Mar. 29--Hospitals in Pennsylvania continue to clash with a state agency over the severity of infections that people acquire while in a hospital.

The state agency, the Pennsylvania Health Care Cost Containment Council, says hospital-acquired infections are responsible for hundreds of millions of dollars in avoidable medical costs and should make patients and insurers question what they're getting for their money.

The Hospital & Healthsystem Association of Pennsylvania says the council is exaggerating the size of the problem and doing more harm than good.

The U.S. Centers for Disease Control and Prevention considers hospital-acquired infections a serious problem that kills about 100,000 people nationwide annually.

In a report being released today, the Pennsylvania Health Care Cost Containment Council says hospitals in the state reported 13,711 such infections during the first nine months of 2005. It says the infections were associated with 1,456 deaths and $2.3 billion in additional hospital charges.

For the first time, the council provides data on what health insurers actually pay to treat patients with infections. It says insurers paid an average of $60,678 for patients who got an infection, compared to $8,078 for those who didn't. Marc Volavka, executive director of the council, said the data "underscores that the problem of hospital-acquired infections is larger and more costly than originally estimated."

But the hospital association, known as HAP, said the report "grossly exaggerates the actual impact on the health care system, insurers and taxpayers."

"We'd like to have a more credible analysis of the problem so doctors and nurses and others who are engaged in initiatives to eliminate infections have good information on which to take action," said Paula Bussard, HAP's senior vice president of policy and regulatory services.

Bussard said the council's estimates of infection-related costs are useless because they lump all patients together, rather than separating relatively healthy patients from severely ill patients. The sickest patients are likely to have complications that result in huge hospital charges.

That makes the gap between costs of patients who got an infection and those who didn't look larger than it should, she said.

HAP also said the council fails to account for the fact that some patients, because of their particular illness, are more vulnerable to infections.

Volavka acknowledged that it's impossible to pinpoint how many deaths were the direct result of infections. But he said 13 percent of patients who got an infection died in 2005, while the death rate for hospital patients who didn't get an infection was only 2.4 percent.

"If you are admitted to the hospital and develop [an infection], you are almost 5 1/2 times more likely to die. I don't like those odds," he said.

Bussard said hospitals realize that infections are a problem and are working to eliminate them. No scientific data shows to what extent they can be reduced, she noted.

Dr. Richard Shannon at Allegheny General Hospital believes most, if not all, hospital-acquired infections could be eliminated. But it takes the same effort hospitals devote to matters like organ transplants, he said.

"You must be dedicated to executing perfectly," he said.

Allegheny General has received national attention for infection control. It reduced central-line infections from 49 to three during a 2 1/2-year period. Infections among pneumonia patients on ventilators dropped from 45 to eight.

Shannon said Allegheny General believes those efforts saved 47 lives and $2.2 million dollars.

He said the council's estimates of the costs of infections are similar to Allegheny's data, and he wonders why HAP is disputing them.

"We clearly get paid more [when a patient gets an infection], but it costs more. It was the realization that we were losing money that caused our leadership to say enough is enough, let's fix this," he said.

Only a few states collect data on hospital-acquired infections, and Pennsylvania is the first to analyze and publish the results.

It's impossible to know if infection rates are higher in Pennsylvania hospitals than in hospitals in other states, Volavka said.

Volavka was scheduled to testify today before a U.S. House committee that's looking into efforts to report on hospital infection rates.

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Source: The Patriot-News

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