State Releases Flawed Hospital Infection Data

Surgeons in an operating room. (stock photo)

Surgeons in an operating room. (stock photo)

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Monday, January 3, 2011 | California health officials last week released the first required statewide report on infections contracted by patients while they were in the hospital but have already acknowledged the figures are so flawed the public shouldn’t put any stock in them.

Some of the state’s roughly 375 acute care hospitals failed to file the mandatory information at all, some filed only bits of it, and not every hospital used the same definitions and criteria for filling out reports.

There are “a lot of limitations” on the quality of the numbers, said Kevin Reilly, chief deputy director for policy and programs for the California Department of Public Health, which was responsible for collecting and releasing the data.

The California law that now requires hospitals to annually report how many patients contract any of four serious infections was spearheaded by Carole Moss, whose 15-year-old son Nile died of an infection contracted at a Children’s Hospital of Orange County (CHOC) facility.

California is the last of the largest states to require hospital-by-hospital infection data. At least 27 states require public disclosure.

An estimated 13,500 California hospital patients die each year of infections they acquire in the hospital, according to a 2009 report. That’s more than four times the number of people killed in state traffic accidents last year.

Reilly and other officials said they were unable to produce a useable report because of a staffing shortage caused by a state hiring freeze, which kept them from training enough workers to collect the data.

Reilly said the report, which was required by Jan. 1 under a recent state law, is a “snapshot of what hospitals are doing” but is too inaccurate to be used to compare hospitals.

For example, one of the four infections that hospitals were required to report is Clostridium difficile, or C. diff, one of the most common hospital-contracted infections. It causes diarrhea and more serious intestinal conditions such as colitis.

But if hospitals reported figures for fewer than four of the five quarters of calendar 2009 through March 2010, their numbers weren’t made public; hospitals that reported for all five of those quarters were included in the report.

In Orange County, those that filed incomplete reports included Anaheim Regional Medical Center, which reported for two of the five quarters; Garden Grove Hospital and Medical Center reported for only one quarter; and Kindred Hospital in Westminster reported only two quarters.

In addition, numerous health officials warned that a system has to be developed for comparing hospitals that treat similar caseloads so that consumers don’t wind up comparing a small community hospital without an intensive care unit to a regional health center that treats high-risk patients.

Nothing can be done to hospitals that failed to report in the past, according to officials with the state health department, but Reilly said that going forward the department will be able to use fines and possibly act against the licenses of hospitals that fail to file reports.

To ensure uniformity, Reilly said hospitals will file new reports through the Centers for Disease Control and Prevention’s National Healthcare Safety Network.

“We’re sure we’ll have 100 percent compliance going forward,” said Reilly. He added that accurate results are “very important for improved healthcare generally.”

A total of 240,000 patients statewide are estimated to contract infections in hospitals each year, and the extra care required to treat them costs $3.1 billion.

Two of Orange County’s largest hospitals, University of California Medical Center, Irvine, and CHOC, say a five-year-old infection control program has produced dramatic results among those most vulnerable. The hospitals care for some of the county’s sickest patients.

To download a pdf file of the hospitals that fully or partially reported infection rates, visit the California Department of Public Health website.

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