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| Critical: Disclosing hospital-infection rates Hospital-acquired infections affect about 1 in 20 hospital patients, according to a report from the Institute of Medicine, part of the National Academy of Sciences. Such infections add almost $5 billion a year to our nation’s health-care bill. More people die from such infections than from auto accidents and homicides combined. James Lee, of Fort Wayne, Ind., was among the roughly 90,000 Americans who die each year from a hospital-acquired infection. Lee went into the hospital for chemotherapy in January 2002. There, he developed a staph infection. Despite antibiotics and isolation, he died in less than three weeks. “We were told to wear gloves, gowns, and masks to keep Dad free from germs,” says his daughter, Lori Egolf. “I knew my dad was going to die of cancer, but with this, he didn’t even know what hit him.” Many of those deaths are preventable. Researchers have found that improved infection-control practices can reduce the rate of in-hospital infection by 10 to 70 percent. Studies of comprehensive hospital programs designed to address all types of hospital-acquired infections have found reductions of more than 50 percent. But though simple hand-washing has been shown to reduce hospital infections significantly, hand-washing compliance rates are generally less than 50 percent. To increase public awareness and to provide strong incentives for hospitals to more rigorously address this problem, Consumers Union has initiated the Stop Hospital Infections campaign. CU is working to make infection rates and quality-of-care information public. Many hospitals track their own infection rates, especially in intensive-care and neonatal units. However, the few hospitals that voluntarily report to the federal Centers for Disease Control and Prevention or to the agency that accredits hospitals for Medicare are assured that hospital-specific information will be kept secret. That prevents them from comparing their performance with that of other area hospitals, and also keeps patients, employers, and insurers from distinguishing the best hospitals from the worst. Requiring hospitals to disclose their infection rates is a strong incentive to improve. Results of a recent study published in the journal Health Affairs “provide strong evidence that making performance information public stimulates quality improvement in the areas where performance is reported to be low,” according to the authors of the study. States are beginning to take action. Illinois and Pennsylvania are pursuing initiatives to make hospital-infection rates public. Policymakers in both states acted after publication of investigative reports about hospital-acquired infections in The Chicago Tribune and The Pittsburgh Tribune-Review. Consumers Union has worked to ensure that recent federal patient-safety legislation doesn’t preclude states from requiring public reporting of hospital-specific infection rates. The campaign also advocates the passage of state public-disclosure laws. Preventable hospital infections cost billions of dollars a year, including the expenses of extended hospital stays and additional medication. Consumers Union wants to ensure that hospitals reduce the rate of infections and that people have the information they need to choose hospitals that achieve low infection rates and avoid those that don’t.
Then & now: Working up a sweat
When we tested stationary bicycles in 1971, we were intrigued by the Exercycle 210 (left), an electric model with “fairly
sophisticated instrumentation”; it cost $800, eight times the top-rated bike. Its handlebar, seat, and pedals moved rhythmically
while instruments in a box monitored the user’s effort. |
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