Most people come to a hospital expecting to get better. But many don't realize that on average, one in 20 patients admitted to a hospital in the United States will contract an infection during his or her stay. These infections cause a staggering 99,000 deaths per year. And a growing proportion of these infections no longer respond to a wide range of antibiotics. Doctors must turn to more costly antibiotics or ones with more side effects - if they can cure the infection at all.
A 2005 report showed that hospitals could charge the cost of health care-associated infections to third-party payers such as Medicare and Medicaid. Medicare has changed its rules in response to these concerns and will no longer reimburse hospitals for the excess costs associated with the care of patients who contract a hospital-associated infection. But now hospitals have no incentive to accurately report their infection levels. If Medicare were to provide hospitals with more resources for infection control, rather than just penalize them for caring for very sick patients who contract a hospital-associated infection, hospitals might perform better.
Baltimore hospitals are on the front lines in the fight against these infections, many of which are caused by "superbugs" - infections resistant to most common antibiotics. The Baltimore Health Department reported last month that the rate of infections caused by the superbug methicillin-resistant Staphylococcus aureus (known as MRSA) runs twice as high in Baltimore hospitals as in neighboring regions. Often, the disease can be detected with only expensive screening programs.
Last month, the U.S. Department of Health and Human Services released a plan urging hospitals and other health care facilities to adopt increased use of sterile techniques and follow strict protocols to prevent such infections. These include guidelines on the proper insertion of catheters and disinfection of ventilators, as well as practices that minimize risk of infection before, during and after surgery.
The University of Maryland Medical Center screens all patients at high risk for MRSA when they are admitted. Screening includes patients in intensive care units and those who have been in another health care facility during the past year. The tests are repeated during the hospital stay. Isolation precautions are instituted for those who test positive for MRSA. During the past year, the hospital has performed more than 33,000 MRSA screening tests. This aggressive action has slashed the hospital's rate of MRSA infection by more than 30 percent and has saved lives.
