When Gov. Arnold Schwarzenegger vetoed a 2004 infection-reporting bill, fewer than a half-dozen states had passed laws requiring hospitals to inform the public about infections that patients acquired at hospitals.

In just six years, all that has changed.

Today, at least 27 states require public disclosure. Most have websites that allow consumers to compare infection rates among hospitals; several, like New York and Illinois, show multiple years of statewide trends.

Schwarzenegger’s signature on Nile’s Law in 2008 made California the last of the largest states to require hospital-by-hospital infection data. The new California reports, to be released Jan. 3, will give consumers information about four kinds of hospital-acquired infections.

Driving the push for transparency have been myriad patient-safety groups that believe publicity will force hospitals with high infection rates to fix the problem. Some have been joined by state hospital associations.

Experts believe that most infections are preventable if hospitals enforce basic procedures such as hand-washing and better housekeeping. Beyond the harm suffered by patients, hospital infections are extremely expensive. A single infection can cost a hospital $30,000 to $70,000 in extra patient care.

In some states, patients with infections led the way. They include Jeanine Thomas, a victim of a staph infection who enlisted scientists and health leaders to pass the 2003 Illinois reporting law, one of the first in the United States. She went on to help pass a patient-screening bill in 2007 with the help of the Illinois Hospital Association.

She found that some hospital leaders did not know the scope of infections in their own hospitals.

“Nothing was being done. Nothing was being said. The CEOs of the hospitals didn’t know. Infection control was in a silo,” said Thomas, founder and president of the MRSA Survivors Network.

New York followed in 2005 with a law requiring hospitals to report infections to the state health department, with annual reports posted on the department’s website. One staunch backer was former Lt. Gov. Betsy McCaughey, founder of a national group focused on infections.

The state of Washington took another tack. After the state passed its own reporting laws, the Washington State Hospital Association took on the job of assembling the data and making it public on a special website, www.wahospitalquality.org, along with state and national averages.

The California Hospital Association says it has no plans to do the same with California’s data. “We’re not going to duplicate what” the state is doing, said Jan Emerson-Shea, the group’s vice president for external affairs. She said the hospital association would wait to see the data’s presentation before deciding whether to link to it on its website.

In most states, infection data is too new to determine whether the publicity is curbing infections.

But Pennsylvania’s reporting law has been followed by a steady decrease in infections, the Wall Street Journal reported in October 2009. It quoted a former Hershey executive saying, “I would ask officials in Washington to push for mandatory compiling of medical data.”

Summaries of the laws in the 27 states with mandatory reporting are posted on the website of the Safe Patient Project of Consumers Union.

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