WASHINGTON — Hoping to erase a troubling legacy of preventable infections and deaths, most U.S. hospitals on Jan. 1 will begin reporting the number of patients who contract bloodstream infections following their treatment in intensive-care units.
The information about infections involving catheters will be made public on a government website later in 2011, giving consumers a fast, easy way to see which hospitals best protect patients from one of the most lethal, yet avoidable medical conditions.
Catheters are tubes used to draw blood or provide fluid or medication to patients. They're commonly inserted into a patient's large vein, usually in the chest, neck, arm or groin, and can remain in the body for several weeks. Infections result if bacteria or germs travel through the line and into the bloodstream.
Nearly 250,000 bloodstream infections occur each year in U.S. hospitals due to catheters, and they contribute to roughly 31,000 patient deaths annually. But research shows that nearly all the infections are preventable when safety measures are used consistently by hospital staff.
The new reporting requirement for the infections is technically voluntary. But if any of the nation's 4,300 acute-care hospitals don't comply, they would lose 2 percent of their Medicare funding beginning in fiscal year 2013.
That financial carrot plus public scrutiny of hospital infection rates will ensure strong compliance. More important, experts say, is that the new measure will focus more attention on hospital hygiene, which should improve patient safety and shorten the average length of hospitalization.
It's the latest move by the federal government to force hospitals to step up the fight against health-care-related infections and a host of virulent superbugs that are growing more resistant to antibiotics. Beginning in 2012, hospitals will have to report the number and rate of surgical site infections, which occur more than 290,000 times a year and claim more than 8,200 lives.
The new mandates are good news for Ed Lawton of Fairfax, Va., who has to use a wheelchair after being stricken with three infections while he was hospitalized for back surgery in 1998.
"I used to lie in bed and think 'I can die just because someone forgot to wash their hands,' " Lawton recalled this week. "At least now, some information will be available to give the public a sense of whether they're going into a hospital that has a chronic problem. We all should have an expectation that we're not going to go to the doctor and get worse."
But sadly, that's exactly what happens to five to 10 percent of patients who contract a health-care-associated infection while hospitalized.
The Centers for Disease Control and Prevention estimates that Americans contract 2 million infections a year while receiving medical care and pay about $6.5 billion for the extra treatment. About 1.7 million health-care-associated infections occur in U.S. hospitals. They lead to about 90,000 preventable deaths annually, the CDC estimates.
That would make infections from medical care the sixth most frequent cause of death in the U.S. in 2007, the last year that annual mortality data is available.
Only heart disease, cancer, strokes, lower respiratory diseases and accidents killed more Americans that year, according government figures.
The new rule calls for acute-care hospitals — those that provide 24-hour care and have emergency rooms — to report four times a year on the number and rate of patients who get catheter-related bloodstream infections in intensive care units and in neo-natal intensive care units.
The data for each hospital will be publicly reported later next year on the Hospital Compare website of the U.S. Department of Health and Human Services.
In October 2008, Medicare stopped paying for the treatment of certain infections that patients contracted while in a hospital. In addition, HHS is also planning to publicly report individual hospital data on eight other health-care-acquired conditions, including infections specifically caused by vascular catheters and catheter-related urinary tract infections, which are the most common infections that occur during treatment.