The U.S. government could do far more to force hospitals to prevent infections that kill up to 99,000 people every year, according to a nonpartisan congressional report released on Wednesday.
It recommended that regulators consider mandating certain core standards — from something as simple as hand-washing to more complex measures — and that the government tie reimbursement to whether hospitals comply.
Setting priorities for which measures work best could help contain some of the $5 billion in extra costs from infections caught in facilities such as hospitals in the United States, the Government Accountability Office report said.
It criticized the U.S. Department of Health and Human Services for failing to coordinate data across agencies and not requiring hospitals to apply recommended practices.
"HHS is not exploiting its leverage to reduce or eliminate hospital acquired infections," Cynthia Bascetta, director for health issues at the Government Accountability Office told a U.S. House of Representative committee hearing on Wednesday. "We concluded that leadership from the secretary is required."
Experts said that while mandating proven practices would be relatively inexpensive, health care practitioners would need payment incentives and guidance on the best proven methods from regulators and accrediting agencies.
Medicare, the state-federal health insurance plan that spends nearly $400 billion on care for about 44 million elderly and disabled people, last week expanded a list of hospital-acquired conditions for which it would cut funding.
Experts said those efforts need to be expanded.
Don Wright, a public health official at HHS, acknowledged efforts are needed to improve coordination among agencies.
"HHS recognizes more work and leadership is necessary to enhance patient safety in this regard," Wright told the hearing.
In the U.S. health care system, providers are generally paid on a fee-for-service basis, which rewards excess care, experts said.
"Unfortunately in some ways we get what we pay for," Leah Binder, the chief executive at the Leapfrog Group, a nonprofit that represents employers, who finance much of the health care in the United States.
"We pay the same even when errors occur that jeopardize a patient's health or life; indeed we pay more for poor performance," said Binder, a former hospital executive.
Another culprit is the focus on trendy new drugs and technologies instead of on infection prevention and correct patient care, Peter Pronovost, head of the Quality and Safety Research Group at Johns Hopkins University, told the panel.