The nation's hospitals are failing to protect patients from potentially fatal infections despite years of prevention campaigns, the government said Tuesday.
The Health and Human Services department's 2009 quality report to Congress found "very little progress" on eliminating hospital-acquired infections and called for "urgent attention" to address the shortcomings — first brought to light a decade ago.
Of five major types of serious hospital-related infections, rates of illnesses increased for three, one showed no progress, and one showed a decline. As many as 98,000 people a year die from medical errors, and preventable infections — along with medication mixups— are a significant part of the problem.
Such medical missteps will have financial consequences under President Barack Obama's new health care overhaul law. Starting in a few years, Medicare payments to hospitals will be reduced for preventable readmissions and for certain infections that can usually be staved off with good nursing care.
HHS Secretary Kathleen Sebelius called the report "a pretty clear diagnosis of some of the gaps and shortcomings in our nation's health care system."
Although the U.S. spends about $2.5 trillion a year on medical care, patients often don't receive the care recommended for their particular condition. Generally, patients are more likely to receive optimal care in a hospital as compared to an outpatient facility. The quality report was accompanied by a second study that found continuing shortfalls in quality of care for minorities and low-income people, particularly the uninsured.
The bleak statistics on hospital infections were a disappointment for officials. It's been more than 10 years since the Institute of Medicine launched a crusade to raise awareness about medical errors and encourage providers to systematically reduce and, if possible, eliminate them.
"We know that focused attention to eliminating health care acquired infections can reduce them dramatically," said Dr. Carolyn Clancy, head of the Agency for Healthcare Research and Quality, which conducted the studies. It marked the first time her agency attempted a comprehensive assessment of progress on hospital infections. The statistics for 2007 were the latest available.
According to the report:
- Rates of bloodstream infections following surgery increased by 8 percent.
- Urinary infections from the use of a catheter following surgery increased by 3.6 percent.
- The overall incidence for a series of common infections due to medical care increased by 1.6 percent.
- There was no change in the number of bloodstream infections due to central venous catheters — tubes placed in the neck, chest or groin to administer medications, drain fluids or collect blood samples.
- Rates of pneumonia following surgery dropped by 12 percent, the one bright spot.
The bloodstream infections are the most serious, said Clancy, because they can be fatal. Recovery from hospital-acquired pneumonia usually depends on the overall health of the patient. Urinary tract infections are painful, but they usually respond to treatment with antibiotics. But any complication for patients in the hospital is of concern.
"If you are looking at patients who are hospitalized, you are looking at people with multiple underlying conditions, who are already fighting for their health on several fronts," Clancy said.
The hospital industry said it was disappointed by the findings, but hopes the next round of studies will show improvement. Some recent efforts to reduce infections may not yet be reflected in the data.
"We're doing that which we know how to do, and it's not having the intended effect," said Nancy Foster, vice president for quality and safety at the American Hospital Association. "We need to identify other things we can do to drive down that rate of infections."
It is possible to turn the tide — and radically. Some 100 hospital emergency rooms in Michigan have reduced the rate of central catheter infections to near zero, said Clancy. It's accomplished by painstaking attention to procedure.