Hospital infections add insult to injury

There's an old joke about cemeteries being such popular places that people were dying to get into them. The opposite sentiment could be expressed about hospitals, from which patients are literally dying to get out. In fact, the facilities that once tended to the sick instead have become breeding grounds for illness themselves.

The Pennsylvania Health Care Cost Containment Council earlier this month released a report that revealed 19,154 patients in Pennsylvania contracted an infection while hospitalized last year, and 2,478 of them died from those infections.

The report, which was the first comprehensive state-led effort to collect hospital infection data, also found that the average length of hospital stays for patients who acquired infections was about 23 days, compared with just five days for those who did not acquire infections. Moreover, the mortality rate for patients with hospital-acquired infections was 12.9%, compared with 2.3% for those who did not acquire infections.

Nationally, the U.S. Centers for Disease Control estimates that between 5% and 10% of patients admitted to hospitals each year acquire one or more infections during their stays and 90,000 of those infections are fatal.

Given those frequency rates, nearly everyone has a story to tell about someone they know who contracted a hospital-acquired infection, and I am no exception.

A couple of years ago, my younger brother suffered a multiple fracture of his left arm and was rushed to a Colorado hospital to undergo emergency surgery. Less than a week later, his arm swelled up and he developed a fever. He was readmitted after his doctor determined that his blood and bone marrow had become infected with staphylococcus aureus, more commonly known as "staph," a bacterium that proliferates in hospitals.

The Leapfrog Group recently challenged the nation's hospitals to commit to its new "Never Events" policy, which includes not only apologizing to the injured patient for such adverse events, but also waiving costs associated with treating them. Instead, most hospitals, like that which treated my brother, seek reimbursement from patients and their insurers for treating their own mistakes. Instead of an apology, my brother received dunning notices while he was confined to his home recuperating.

Fortunately, my brother recovered. But because of the additional costs associated with treating his infection, the tab for hospitalization and ambulatory care ballooned from what should have been just a few thousand dollars into the tens of thousands of dollars.

Such additional costs are typical, according to an August 2005 study published in the Archives of Internal Medicine, which found that hospital-acquired staph infections usually result in lengths of stay and hospital charges that are three times what they would have been had the infections never occurred. In Pennsylvania, the average cost of hospital care for patients who acquired infections was actually closer to six times what they should have been: $185,260, compared with $31,389 for those who did not acquire infections, according to the cost containment study.

The Leapfrog Group should continue to pressure hospitals to take responsibility for the additional costs of treating patients who suffer from serious reportable adverse events, including infections, in their facilities. As my brother can attest, allowing hospitals to bill patients for their medical errors does nothing more than add insult to injury.