11,668 confirmed hospital-acquired infections in 2004 in Pennsylvania
The hospital admissions in which these infections occurred were associated with 1,793 deaths, and an estimated 205,000 extra hospital days and $2 billion in additional hospital charges. These numbers are out of a total of 1.5 million discharges from 173 general acute care hospitals.
"This seminal report demonstrates without question that the cost and quality implications of potentially preventable hospital infections are astounding," stated Marc P. Volavka, Executive Director of PHC4. "This first snapshot of statewide numbers should be a wake up call for all parties involved in the delivery and payment of hospital care."
Pennsylvania is the first state in the nation to begin collecting and reporting information about hospital-acquired infections. Beginning in 2004, hospitals were required to start submitting data on four types of hospital-acquired infections to PHC4: three surgical site infection categories; and Foley catheter-associated urinary tract infections, ventilator-associated pneumonia and central line-associated bloodstream infections. As of January 1, 2006 hospitals will be required to submit data on all hospital-acquired infections to PHC4.
During this process, PHC4 has expressed its concern regarding the wide variation in reporting levels among hospitals in the state. "As we started down this uncharted path, we said from the beginning that it would take time for Pennsylvania's hospitals to become accustomed to this reporting process, and the Council continually worked with individual hospitals and the Hospital Association of PA (HAP) to provide lenient timeframes and extensions to hospitals having difficulty," said Mr. Volavka.
However, 29 hospitals (17%), which account for 25% of ALL statewide admissions, reported more than half (50.6%) of the 11,668 hospital-acquired infections. Several large hospitals submitted invalid infection data for the majority of their discharges. Sixteen hospitals, including several large hospitals, reported no infections at all.
"The Council is continuing to work with HAP, and these hospitals, to encourage full compliance, and we believe overall that they are making a good faith effort. However, results from the first full year of data collection indicate that while some hospitals worked very hard to meet the hospital-acquired infection data collection requirements, other hospitals provided only minimal information," said Mr. Volavka. He noted there was a steady increase each quarter of 2004 in the number of hospital-acquired infections reported; yet, submission disparities among hospitals raised some concerns regarding the accuracy and completeness of the reported data.
"While we recognize and applaud the Pennsylvania hospital community for their significant participation in several new patient safety initiatives, including the Institute for Healthcare Improvement's 100,000 Lives Campaign (http://www.ihi.org/ihi), and the surgical infection prevention project with Quality Insights of Pennsylvania (QIP), the cost and quality implications of hospital-acquired infections cry out for continued focus and more resources," said Mr. Volavka.
One of PHC4's major interests is the discrepancy between the number of hospital-acquired infections reported by hospitals (11,668) and the 115,631 infections billed to purchasers, private insurers and government programs like Medicare and the state's Medical Assistance program. PHC4 screened the 2004 billing data for diagnoses that may possibly indicate the presence of a hospital-acquired infection. While it is reasonable to assume that not all these infections are acquired in the hospital, these billed infections suggest the possibility of more hospital-acquired infections than those confirmed by hospitals and reported to PHC4.
There has been no release of data on a hospital-by-hospital basis, he said, because this could penalize hospitals that have more fully and completely reported their data to PHC4. "We made a commitment to our hospital community that we would NOT release hospital specific data until we could reasonably assure ALL hospitals that we were comfortable with the accuracy and completeness of the reporting," said Mr. Volavka.
PHC4, also for the first time, was able to look at actual payment data for these occurrences. Previously, all cost assumptions were based on hospital charges, which are not what hospitals are actually paid in heavily discounted arrangements with insurance companies. The newly submitted payment data from third party payors shows that in 2003, the average payment for the treatment of a patient with an infection was more than $29,000, compared to an average payment of $8,300 for a patient without an infection.
"Those who pay for health care in Pennsylvania (and that's ALL of us) are paying four times as much for potentially preventable infections occurring every day in our hospitals" said Mr. Volavka.
Assuming payments remained static between 2003 and 2004, PHC4 estimates that third party insurance payments (distinct from hospital charges) for just the 11,668 reported infections were nearly $350 million annually. "Quality improvement efforts must be redoubled, and hospital Boards and CEOs, along with those paying the bills, must insure that infection control departments and their dedicated staff get the support and resources they need to reduce infections to the most minimally acceptable level. The quality case is imperative, the business case is compelling," stated Mr. Volavka.
The Pennsylvania Health Care Cost Containment Council is an independent state agency charged with collecting, analyzing and reporting information that can be used to make more informed decisions, thereby improving the quality and restraining the cost of health care in Pennsylvania.
Copies of the new Research Brief are free and can be ordered by calling PHC4 at 717-232-6787 or can be downloaded from PHC4's Web site at http://www.phc4.org
11668 confirmat spital-infecþii dobândite în 2004 în Pennsylvania - 11,668 confirmed hospital-acquired infections in 2004 in Pennsylvania - articole medicale engleza - startsanatate