Sepsis and pneumonia, two infections that can often be prevented with tight infection control practices in hospitals, killed 48,000 patients and added $8.1 billion to heath care costs in 2006 alone, according to a study published today in the Archives of Internal Medicine.
Researchers analyzed 69 million discharge records from hospitals in 40 states between 1998 and 2006; the length of stay and mortality rates for the infections didn’t change substantially over time, the study found, and high infection rates persist.
The news, principal investigator Ramanan Laxminarayan tells the Health Blog, is that the study for the first time links about half of all infection deaths directly to infections acquired in the hospital in the course of care.
While the Centers for Disease Control and Prevention estimates there are 1.7 million hospital infections and 99,000 associated deaths each year, he says, those numbers don’t calculate deaths caused by, rather than merely associated with infections patients get in the hospital. The CDC figures also are based on voluntary reports by hospitals, whereas the new study is based on data about patient diagnosis, hospital treatment and exposure to infections prior to hospital admission.
While in many cases sepsis and pneumonia could have been avoided with better infection control in hospitals, Laxminarayan says, one issue is getting the financing to set up infection control programs. “Even when physicians are gung-ho to do something about infection control, they may not have buy-in from hospital administrators,” he says. “They may still ask why do you need $500,000 if it isn’t going to do anything for the bottom line?”
While Medicare has announced its decision to cease paying hospitals for some of the care made necessary by “preventable complications” such as infections, penalties may not be enough to incentivize better infection control if hospitals knowingly misclassify infections to avoid penalties, or if problems documenting the infections prevent adequate enforcement, the study notes.
The study was funded by the Robert Wood Johnson Foundation as part of Extending the Cure, a project examining antibiotic resistance. The project is based at the Washington think-tank Resources for the Future, where Laxminarayan is a senior fellow.
Accompanying the study is an editorial co-authored by Johns Hopkins Hospital safety guru Peter Pronovost, creator of one of the checklists used by hospitals to prevent infections. While he says the estimates in the study may have some “systematic errors” in calculating costs and mortality, “they suggest a substantial opportunity to reduce patient harm.”