Tracking hospital infections

State law requires institutions to report number of patients who get ill


Under a new law that takes effect this summer, Maryland hospitals will have to report infections acquired by their patients.

But a more stringent measure that would have required hospitals to test many incoming patients for infections died in committee during the General Assembly session that just ended.

The reporting measure passed both houses unanimously, and Gov. Robert L. Ehrlich Jr. signed it April 8.

Some patient advocates, legislators and the Maryland Hospital Association say the law will help make the state's hospitals safer by encouraging them to lower infection rates.

"[The bill] will cause the hospitals to want to look good, and allow people to make informed choices," said Del. Shane E. Pendergrass, a Howard County Democrat who sponsored the bill in the House.

Some hospitals already collect data on hospital-acquired infections, but they have not made the information public. The new law will require hospitals to begin reporting data July 1 to the Maryland Health Care Commission, which will post the information on its Web site.

Critics say the measure will make little difference in the rate of hospital infections, which most health officials agree is a growing problem.

"Reporting doesn't make hospital infections go away," said Dr. William Jarvis, a former Centers for Disease Control and Prevention epidemiologist and infection control consultant based in South Carolina.

He and other skeptics argue that hospitals can easily avoid the appearance of high infection rates by not looking very hard for the ailments.

At the same time, Jarvis said, some institutions that do report more infections may not actually be more dangerous; often they treat sicker patients who are more vulnerable to the ailments.

Every year, 2 million people contract infections while in the hospital, according to the CDC. About 90,000 die, the agency says. Many experts say public officials and hospitals are not working hard enough to deal with the issue.

The Maryland Hospital Association supported the reporting bill. But the group opposed the second bill sponsored by Sen. Paula C. Hollinger, a Baltimore County Democrat who chairs the Education, Health and Environmental Affairs Committee, and Sen. Lisa A. Gladden, a Baltimore Democrat.

That legislation would have required hospitals to test many incoming patients and isolate those who turned out to have infections.

"We think the reporting bill really advances what the process has been in Maryland," said Nancy Fiedler, executive vice president of the hospital association. She said that the group "supported the concept" of the second bill, but that its requirements were too rigid.

"We needed some flexibility to make progress," she said. "Hospitals have a variety of different programs in place." She denied an assertion by Gladden and other critics that the group's opposition stemmed from a fear of increased costs.

Some experts say that unless hospitals are compelled to test patients and isolate those with infections, the problem will grow worse.

"I really am pessimistic that publishing a hospital's infection data will have any effect on the problem, which is egregiously out of control," said Dr. Barry Farr, an infectious disease specialist at the University of Virginia. "Taking no action is indefensible."

Gladden said she will introduce the tougher bill again in the 2007 legislative session. "I'm disappointed, but I'll bring it back next year," she said. "I'm optimistic."

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