Q&A: Hospital Infection Rates Rarely Disclosed Despite Thousands of Deaths

ByABC News

Oct. 14, 2005 — -- Millions of patients contract an infectious disease while they are being treated in a hospital, but most hospitals do not release detailed data on the problem.

Consumers Union, the nonprofit publisher of Consumer Reports, is spearheading a nationwide campaign to require hospitals to disclose their infection rates.

Charles Bell, the programs director of Consumers Union, recently sat down with "20/20" producer Susan Wagner to talk about the prevalence of hospital infections and how public disclosure of infection rates can lead to safer hospitals.

Susan Wagner: People are often surprised by how prevalent hospital infections are.

Charles Bell: Consumers think of hospitals as places that you go to get medical treatment, to be healed and to get well. They would be surprised to learn how dangerous it is to go to hospitals. In fact, about one out of every 20 patients experiences a hospital-acquired infection each year. That translates into 2 million people – 90,000 people who die each year. That's more than auto accidents and homicides combined.

Wagner: Doesn't the CDC (Centers for Disease Control and Prevention) monitor hospital infections for us?

Bell: Well, they do track large national trends. But unfortunately, there is no public reporting of specific hospital infection rates for each hospital. We think it would be very much in the interest of consumers to make that information available to the public, so that consumers can compare the track record of different hospitals in their community. And if a hospital has a high rate of infections, they could avoid that hospital, and perhaps choose a different one.

Wagner: Pennsylvania made big headlines this summer as the first state in the nation to report its number of hospital-acquired infections. Your campaign wants more states to follow their lead. What do you think they're doing right?

Bell: Pennsylvania is one of the six states that have adopted measures to create a public report card for how well hospitals are doing and controlling infections. We think this is a tremendously important step forward because the public disclosure of performance information can really drive quality improvement for patient safety. Having that information is a key to giving hospitals the incentive they need to dramatically reduce these [infection] rates.

Wagner: Many hospitals argue that most hospital-acquired infections are simply unavoidable – the unfortunate result of sick people coming into contact with powerful germs. How would publicizing rates change that?

Bell: Studies have shown that hospitals can reduce infection rates by as much as 70 percent through simple techniques, such as improving their hand washing. But in fact, many hospitals are not implementing those practices. One of the things that concerns us is that there's sort of a culture of inaction, or a culture of secrecy, that's grown up about infections. It's almost like the hospitals don't see this as an essential part of giving health care. We're talking about very serious infections that can require weeks, months or years of treatment and rehabilitation – that can result in permanent disability, loss of jobs, if not death.

Wagner: You describe a "culture of secrecy" that surrounds hospital infections. Why don't hospitals want to reveal their rates? Do they even keep track of them?

Bell: Well, we believe that a lot of hospitals track the information. They give it to some of their physicians. Quite frankly, many institutions seem to think it's easier to mitigate the infections after they have them than to prevent them. However, it's clear that the amount of cost that this adds to our health care system, the amount of needless suffering and deaths for patients – it's not something that should be acceptable.

I think as long as we allow the culture of secrecy to continue, you're not going to see the improvement. Once this information is in the public domain, on the public record, sunlight is really the best disinfectant. That will give these institutions the incentive they need to dramatically reduce the rate of infections.

Wagner: You mentioned the financial cost of hospital infections – any idea how much in actual dollars?

Bell: It's something that adds about $5 billion each year to the nation's health care bill. So, when we go around the country to talk to state legislators about why they should pass these bills (requiring public reporting of infection rates), we're getting a very favorable response – because state budgets have a lot of dollars that go for health care programs. States are seeing that it's in their interest to pass this type of a law, to help reduce the rate of patient suffering and injury, and to save money on health care programs.

Wagner: Speaking of legislation and passing laws – shouldn't hospitals just be policing themselves?

Bell: I think the history that we've seen is that hospitals will not police themselves, and having the public disclosure is the key ingredient that's necessary to drive quality improvement. There are six states that have enacted laws now to require what in effect would be a hospital report card on the infections; 35 states have laws pending. We believe that 2006 will be the year when many states step up to the plate, and try to address this question by passing the disclosure law. It's a law that doesn't require a lot of extra cost for the health care system. It's going to be something that helps us as a nation save a lot of money, and save a lot of lives.

Wagner: Wouldn't public reporting of infection rates expose hospitals to lawsuits?

Bell: We don't think so. In the first case, we're only talking about the reporting of the combined infection rate for a hospital. It doesn't give information that violates the privacy of individual patients, or about individual cases. And that has also not been the experience for other types of medical disclosures about the cardiac bypass surgery success rate. There were not lawsuits coming out about that. So, no, we don't think that will be a major outfall of this. We need public accountability in the health care system. And transparency and disclosure is really the first step to creating that type of accountability.

For more information visit, www.StopHospitalInfections.org.

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