Pa. hospital infection study

April 10, 2008 9:22:41 AM PDT
More than 30,000 patients who were hospitalized in Pennsylvania in 2006 contracted infections during their hospital stays, according to a state report being released Thursday.

The numbers rose sharply from the previous year. But officials attributed much of the increase to a change in how the data is collected and improved reporting by hospitals.

The 2006 number was 60 percent higher than in 2005, when hospitals reported more than 19,000 patient infections.

The Pennsylvania Health Care Cost Containment Council cautions that 2006 was the first year in which the institutions were required to report to the state all types of infections acquired in hospitals.

The number of infected patients accounted for 2 percent of the nearly 1.6 million patients whose cases were analyzed - a rate of 19.2 infections per 1,000 patients in the state's 165 general hospitals. About 3,700 of the infected patients died, the report said.

The council did not have a year-to-year comparison of the four types of infections for which data was collected in both years: pneumonia as a result of ventilator use, bloodstream infections, urinary tract infections, and surgical site infections for circulatory, neurological and orthopedic procedures.

But a comparison of the last three months of each year the most similar data-collection periods found that the infection rate per 1,000 patients dropped from 16.3 in 2005 to 15.1 in 2006. The expanded reporting requirements were phased in during the last six months of 2005.

"The decline ... indicates that we are headed in the right direction," David Wilderman, the council's acting executive director, said in a statement.

Pennsylvania is among 22 states that require public disclosure of hospital infection rates, but it is one of only five that have produced reports, said Lisa McGiffert of Consumers Union's Stop Hospital Infections campaign. The others are Florida, Missouri, South Carolina and Vermont.

And among those five states, Pennsylvania is the only one that collects data on all hospital-borne infections, McGiffert said.

"There is no other state in the country that is even close to doing that," McGiffert said.

The report is the second in which the council has included infection rates for specific hospitals. Each hospital is listed alongside its peers, institutions that treat similar numbers of patients and offer similar services.

Among the state's largest hospitals, which treat an average of 25,430 patients annually, Penn State Milton S. Hershey Medical Center in Hershey had the highest infection rate, 47.7 infections per 1,000 patients.

But the hospital is also among three in its peer group and 13 in the report that use computerized systems to track infections, as opposed to having hospital staff review paper files.

Dr. Greg Caputo, the hospital's chief quality officer, said hospitals that switch to electronic monitoring typically see apparent increases in their infection rates because they can gather more comprehensive data. The hospital began reporting its infection rates electronically in late 2005.

"As you detect more cases, it appears that the infection rate increases," Caputo said.

A statewide lobbying group for hospitals said the council has not yet been able to chart consistent trends in infection rates because of the ongoing evolution of its data collection.

"As hospitals report from year to year using the same reporting criteria, we will get a consistently better picture, which will allow for more timely recognition of infection patterns and prompt intervention, which leads to improved patient care," said Carolyn F. Scanlan, president and CEO of the Hospital & Healthsystem Association of Pennsylvania.

This year, the state is requiring hospitals to begin implementing computerized infection monitoring systems under a law signed by Gov. Ed Rendell in July. Institutions that need financial or technical assistance to make the change will be allowed to continue using their current systems.

Cases of hospital-borne infection reported to the state Health Care Cost Containment Council in 2006:
Urinary tract - 13,635
Gastrointestinal - 3,963
Multiple infections (any combination) - 3,732
Pneumonia - 3,326
Bloodstream - 2,945
Surgical site - 1,671
Other infections - 965
TOTAL: 30,237


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