A new report about the high death toll related to healthcare-associated infections was another reminder to some experts that patient safety is not getting the attention it deserves in the national health reform debate.
Pushing for change
Healthcare-associated infections get short shrift: study
Days before President Barack Obama convened a healthcare summit in Washington last week, a study published in the Archives of Internal Medicine reported that 48,000 people died from healthcare-associated sepsis and pneumonia in 2006, which increased U.S. healthcare costs by $8.1 billion. Sepsis is a serious systemic response to infection that the study said could result from pneumonia, but often results from infections at other sites, such as bloodstream infections or surgical-site infections. Pneumonia, a respiratory condition, is caused by inflammation of the lung. In 2006, there were 2.3 million hospitalization days as a result of healthcare-associated infections that caused these two conditions, according to the study.
The disturbing statistics came as no surprise to Leah Binder, CEO of quality-improvement organization the Leapfrog Group. Binder emphasized that results could not begin to account for the amount of human suffering related to extended hospital stays that often resulted in death. And she also said she’s not pleased with either the level of understanding or importance that the health reform debate has devoted to healthcare-associated infections.
“I think the healthcare reform debate has been about insurance reform,” Binder said. “My insurance gives me a plastic card. My physician and hospital give me healthcare,” she added. “When we talk about the need for reform, we ought to go right to the bedside. This is an outrage,” she said of the Archives of Internal Medicine study. “We are paying for the best healthcare in the world, and we’re not getting it.”
While Binder said insurance plans have often been innovative, they do not have the “political clout” to do what is necessary to change the way U.S. healthcare is financed. “That really takes the federal government and the private sector to come together and make demands about what we’re purchasing. When the health plans have that kind of backing from the people who pay their bills, they can be much more innovative and helpful,” she said.
For the Archives of Internal Medicine study, researchers used hospital discharge records from the Nationwide Inpatient Sample database to identify sepsis and pneumonia among 69 million discharges from hospitals in 40 states from 1998 and 2006. They found that healthcare-associated pneumonia affects about 250,000 U.S. hospitalizations a year, while all-cause sepsis affects about 750,000 hospitalizations. Of those cases, about half may be healthcare-associated.
“If the public becomes more aware,” Binder said, “hopefully some of them will become more active in demanding change.”
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