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NY Hospitals Urged to Adopt Aggressive Anti-Infection Protocols

Jul 9, 2008 | Parker Waichman Alonso LLP

New York’s state Department of Health just a released a report revealing that the rate of hospital infection in surgical intensive care units (ICUs) linked to central line intravenous hookups was 3.7 for each 1,000 days that patients had such a hookup.  The 2007 national rate was 2.7 infections for each 1,000 days, showing that NY patients had a 37% greater chance of infection over the national average.  A central line is a tube into a major vein that allows doctors to administer medication or monitor patient condition.

The infection data, which did not include hospital-specific information, was publicized in compliance with a 2005 law requiring NY to track infection trends.  Next year, health officials are expected to publicize infection rates by facility; however, in September, the Health and Hospitals Corporation (HHC)  began publicizing infection and death rates at its 11 hospitals.  "The only acceptable infection rate is zero, so hospitals that settle for being below average are dangerous places to be," said Betsy McCaughey, founder of the Committee to Reduce Infection Deaths,

State health officials said they could not explain the disparity between infection rates in New York and nationwide, however, they said NY City’s rate of central line-associated infections was lower than that in upstate hospitals, and that upstate infection rates raised the statewide average.  In New York City, 2.8 of 1,000 central lines in medical ICUs resulted in infections, compared to 3.6 upstate; 2.7 of 1,000 central lines in surgical ICUs resulted in infection versus 4.8 upstate.

McCaughey criticized the state for leaving infections off a list of preventable hospital errors that the state's Medicaid program will no longer pay for effective October 2008 and compared the state policy unfavorably to a federal policy announced last summer by the Center for Medicare and Medicaid Services, which will not reimburse hospitals for infections and other preventable hospital errors.  "Medicaid has a responsibility to use its purchasing power to pressure hospitals to eliminate infections," McCaughey said. "New York taxpayers should not be paying to treat infections that shouldn't happen."  Meanwhile, a nonpartisan congressional report released in April stated that the U.S. government could do more to force hospitals to prevent infections that are killing up to 99,000 people annually.

Claudia Hutton, a spokeswoman for the state's health department said the new Medicaid policy does not include infections in the list of errors it would not pay for because that initiative was concentrated on the types of things that "never, ever should happen," such as operating on the wrong patient or on the wrong body part.  "Infections you want never to happen, but infections, there's a more likely risk that they can happen," she said.

Last year alone, 94,000 Americans developed MRSA—methicillin-resistant S. aureus; most were infected in healthcare facilities and 19,000 died.  The Centers for Disease Control (CDC) says drug-resistant infections in hospitals must be fought with multiple strategies:  Better hospital hygiene, enhanced cleaning, and testing.