A groundbreaking report being released today says more than 11,000 patients in Pennsylvania acquired infections during their hospital stays last year.

		Graphic: Hospital-acquired infections

The hospital-acquired infections contributed to more than 1,500 deaths, forced patients to extend their stays by a combined 205,000 days and were responsible for about $2 billion in additional hospital charges, the Pennsylvania Health Care Cost Containment Council report said.

The mortality rate among patients with hospital-acquired infections was 15.4 percent, compared with 2.4 percent for all other hospital patients, the report said.

The problem may have been even more extensive, the agency said, noting that some unnamed hospitals reported no infections at all, which was unlikely.

"I think this is a critically important piece of work," said Paul O'Neill, the former U.S. Treasury secretary and Alcoa chairman, who has worked with -- and occasionally clashed with -- local hospitals on the need to improve quality. "This demonstrates the high volume of misadventures with hospital-acquired infections and, even on this under-reported basis, it begins to demonstrate how much of an opportunity there is to reduce human suffering and reduce cost at the same time."

Marc Volavka, the council's executive director, said the report indicates only the "tip of the iceberg" of hospital-acquired infections.

Hospital-acquired infections typically result from inadequate sanitary practices or failure to adhere to infection prevention procedures. Many infections can be avoided through better hand washing or more thorough cleaning of medical instruments, the report said.

The state's hospitals do not have to report data on all hospital-related infections until next year. The totals released today include only infections that resulted from certain surgeries or from the use of catheters, ventilators and "central lines" -- intravenous lines placed in the chest to infuse medications.

Even those data are likely underreported, the report found, noting that several large hospitals submitted invalid data and that 16 hospitals, including several large facilities, reported no hospital-acquired infections.

The report used billing information submitted by hospitals to suggest the number of infections in the selected categories may be nearly 10 times higher.

Roger Baumgarten, a spokesman for the Hospital and Healthsystem Association of Pennsylvania, suggested the number is lower, adding that the estimate cited in the report could include infections acquired before patients got to the hospital, or even reported problems that turn out not to be infections.

But he said that the likely number of infections is "higher than reported by hospitals to date, since it's a new reporting system that's still evolving."

Volavka noted that after the council's May meeting, he was directed to write to hospital chief executive officers urging them to comply with requirements to submit the data. He noted the council can conduct audits or seek fines of $1,000 a day.

He said the council will "absolutely do some audits" if reporting disparities continue, and may pursue fines if evidence indicates that data were not reported.

Hospital-acquired infections were one of the issues that O'Neill challenged hospitals to address through the Pittsburgh Regional Healthcare Initiative, a nonprofit group that has led a variety of quality improvement efforts since the late 1990s. O'Neill resigned as its chief executive officer last year, but remains on its board of directors. Earlier this year, he founded a for-profit company that consults with hospitals on quality issues.

While some Pittsburgh hospitals hang banners that proclaim their quality rank according to U.S. News & World Report magazine, they would better serve the community by posting how long they've gone without a hospital-acquired infection, O'Neill said.

Information about infection rates at different hospitals would be important consumer information, he said, suggesting that real-time reporting of infections to an Internet database should be a long-term goal.

First, though, the council must figure out how to get better numbers.

Cliff Shannon, executive director of SMC Business Councils, which helps small companies buy health insurance, said national estimates of infection rates would suggest Pennsylvania hospital patients suffered between 40,000 and 75,000 hospital infections during 2004.

Hospital infections might seem like an issue that's far afield for the average company buying health insurance, but it shouldn't be, Shannon said. Eliminating preventable infections could provide huge savings at a time when employers are struggling to maintain health benefits.

The leader of a consumer advocacy group called disclosure of information on hospital acquired-infections "the first step toward saving lives and money."

The Cost Containment Council "cannot do its job to protect consumers if hospitals don't do theirs," said Beth McConnell, director of the Pennsylvania Public Interest Research Group Education Fund.

In a statement, Carolyn Scanlan, president of the state Hospital HealthSystem, an industry group, said Pennsylvania hospitals are involved in numerous activities aimed at eliminating those infections.

But Volavka said greater efforts are needed by hospital leaders to get infection rates under control.