Pa. hospital infections rate rises in '06
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The rate of costly, life-threatening hospital infections went up statewide in 2006, according to a new report today from the Pennsylvania Health Care Cost Containment Council.
But the jump, said the council, can be attributed largely to new reporting requirements and better identification procedures -- as opposed to greater hospital error.
This is the second such report from the state-affiliated council, which was the first in the nation to detail rates of infections, deaths, average length of hospital stays and average charges associated with infections on a hospital-by-hospital basis.
"The important thing about the report is that there is a report," said Karen Wolk Feinstein, chief executive officer of the Pittsburgh Regional Health Initiative, a group founded a decade ago to reduce the number of hospital-acquired infections in southwestern Pennsylvania and bring attention to the cause nationally. "This is just a stage in a journey, and the journey we are moving along is getting to the point where every person who comes into contact with a patient is absolutely diligent about observing all known sanitary precautions."
The information in the cost containment council report covers 165 hospitals treating more than 1.5 million patients.
All told, 30,237 cases of infection were reported, or 19.2 per 1,000 cases -- as compared with 19,154 cases the year before, or 12.2 per 1,000 (the council asked hospitals to report infections from all procedures in 2006, a change from 2005). The mortality rate in 2006 was 12.3 percent, compared with 2.3 percent for those without infections. The average charge for infection cases was $175,964, compared with $33,260 without infections.
Among Pittsburgh's largest hospitals, Allegheny General Hospital was highest with an infection rate per 1,000 cases of 26.8, followed by UPMC Presbyterian/Shadyside (22.6); Mercy Hospital of Pittsburgh (19.2), now part of the University of Pittsburgh Medical Center; and The Western Pennsylvania Hospital (15.8).
Mortality rates at those facilities for patients with infections, respectively, were 14.1 percent, 15.3 percent, 8.3 percent and 10.8 percent.
Average lengths of stay for patients with infections were 21.5, 25.1, 17.2 and 20.9 days, respectively, compared with about five days or less for patients without infections. And charges for treating patients with infections were three to five times higher than for treating patients without infections.
Infection rates from hospital to hospital could be different for a number of reasons.
Some hospitals treat a higher number of patients prone to infection, and reporting of infections also varies among different institutions.
"I think that you really can't focus right now on comparisons among hospitals because people are at different stages of reporting." Ms. Feinstein said.
"When you see a hospital with a high rate, all you know is that hospital is good at reporting."
Because reporting requirements were more expansive in 2006 compared with 2005's, thereby skewing any comparative information, the council also examined similar data from the fourth quarter of 2005 and the fourth quarter of 2006. Using that span as a snapshot, the hospital infection rate across the state actually decreased from 16.3 per 1,000 cases to 15.1.
Among Pittsburgh's larger hospitals, Allegheny General's rate dropped from 23.3 to 20.3 during that time; UPMC Presbyterian/Shadyside increased from 14.9 to 17.2; Mercy Pittsburgh dropped from 16.6 to 10.2; and The Western Pennsylvania Hospital dropped from 13.8 to 12.9.
"Initial data patterns seem to indicate that overall, hospitals may be decreasing the incidence of infections occurring within them," said Carolyn Scanlan, chief executive officer of the Hospital & Healthsystem Association of Pennsylvania.
But the council "has not yet been able to establish a real trend in the reporting of infection data because the collection and reporting processes are still evolving …. As hospitals report data from year to year using the same reporting criteria, we will get a consistently better picture, which will allow for more timely recognition of infection patterns and prompt intervention, which leads to improved patient care."
The full infection report can be accessed at www.phc4.org.
First Published April 10, 2008 12:00 am
