Study: Hospital infection problems persist

April 13, 2010
Hospital Infection Problem Persists
By KEVIN SACK
The New York Times

The nagging and largely solvable problem of hospital-acquired infections remains as resistant to cure as the germs that contribute to an estimated 100,000 deaths a year, according to an annual government study issued Tuesday.

Despite a renewed focus on prevention and threats of governmental sanctions, hospitals continue to see increased rates of post-operative bloodstream infections and catheter-associated urinary tract infections, the Agency for Healthcare Research and Quality reported. The rates increased by 8 percent for bloodstream infections and 4 percent for urinary tract infections over the year before.

There was no change in the incidence of bloodstream infections caused by the placement of catheters in central veins. The only positive news came from a 12 percent reduction in the rate of post-operative pneumonia.

The report concluded that hospital-acquired infections merited “urgent attention.”

Dr. Carolyn M. Clancy, the agency’s director, pointed out that projects across the country had shown remarkable success in reducing infection rates by adhering to basic standards for hand hygiene, disinfection of patients, sterile handling of equipment and proper use of antibiotics. But at many hospitals those successes have yet to overcome an entrenched medical culture.

“Despite promising improvements in a few areas of health care,” Dr. Clancy said, “we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access.”

Kathleen Sebelius, the secretary of health and human services, called the trend troubling but said the new health care law would “help turn these numbers around.” Under the law, hospitals with high rates of infections will be penalized by the government starting in the 2015 fiscal year.

The agency has been releasing its Congressionally mandated reports on health care quality and disparities since 2003. Over all, this year’s report found that the quality of care, based on 33 separate measures, was improving but at a slow pace.

The study found deep disparities in access to health care between those with insurance and those without it. For instance, 74 percent of women ages 40 to 64 who had insurance had received a mammogram in the previous two years, compared with 38 percent of those without insurance. Children were twice as likely to have had a dental exam in the past year if they were insured.