More Data on Hospital-Acquired Infections, Please

Pneumonia is among the more common hospital-acquired infections.
Pneumonia is among the more common hospital-acquired infections. The public deserves more transparency.

Hospitals are dangerous places. Americans acquired 722,000 infections in a hospital setting in 2011, the most recent year cited by the Center for Disease Control and Prevention. About one out of twenty-five patients fell victim to preventable hospital-acquired infections.

In the interest of controlling infectious disease, health care officials have begun tracking the data more closely in recent years. In November the Virginia Department of Health published its Virginia-specific findings for 2015. Overall, hospitals in the Old Dominion compare fairly favorably with their peers nationally based on a methodology that adjusts for the acuity of patients and other relevant factors.

But that conclusion is tempered by (a) significant weak spots in Virginia hospital performance, and (b) the fact that the methodology compared only five categories of common infections, not all infections.

That said, here follow the statewide conclusions from the consumer version of the study based on 2015 data. Virginia hospitals exhibited:

  • Fewer bloodstream infections than predicted based on the national experience in 2006-2008.
  • Fewer urinary tract infections than predicted based on the national experience from 2009.
  • More infections following abdominal hysterectomies and about the same number following colon surgeries based on the national experience from 2006-2008.
  • Fewer methicillin-resistant Staphylococcus aureus bacteremia laboratory-identified events than predicted based on the national experience from 2010-2011.
  • About the same number of hospital-onset Clostridium difficile laboratory-identified events as predicted based on the national experience from 2010-2011.

Bacon’s bottom line:

As I argued previously, Virginia consumers/patients should have full transparency into the risks they are taking when they enter a hospital. When I wrote previously, I was unaware that the Virginia Department of Health collected the data. The department deserves kudos for publishing its report in a form comprehensible to the public. But it should go further.

The report lists every hospital in the state and gives it a green star (better than expected compared to national norms) a red X (worse than expected), an equal sign or a “No Conclusion.” This really isn’t very helpful. Does the Depaul Medical Center, to pick a random example, outperform national norms for bloodstream infections by a razor-thin margin or a wide margin? Do Virginia Commonwealth University patients undergoing colon surgeries experience many more infections or just a few?

More to the point, why doesn’t the health department tell us the total of all hospital-acquired infections at each institution and how the numbers compare to national norms?

It also would be helpful to get a sense of what’s happening to hospital-acquired infections over time. To pick an example, it’s nice to know that Virginians incurred fewer bloodstream infections in 2015 compared to the national baseline of 8- to 10-years previously. But that’s a long period of time. How much progress has been made? How rapid has the progress been — have Virginia hospitals made big gains, or are they doing only marginally better than a decade previously?

The cost of health care poses one of the greatest challenges to 21st-century American society. Eliminating hospital-acquired infections should be low-hanging fruit for controlling costs and improving medical outcomes. While Congress argues over Obamacare and the zero-sum question of who subsidizes whom, Virginia needs to take the lead in driving down costs and improving medical outcomes to the benefit of all. Greater transparency can help by making hospitals more attentive to patients’ concerns and by shining a spotlight on under-performers. If  hospital managements fear looking bad in the eyes of the public and its board of directors, they will make the control of infections a top priority.

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15 responses to “More Data on Hospital-Acquired Infections, Please”

  1. LarrytheG Avatar

    here goes the ying and the yang..

    In the interest of controlling infectious disease, health care officials have begun tracking the data”

    Nope.. not “officials” – the government….

    and how come they’re “officials” here and faceless bureaucrats on the Libertarian rants?

    we want Libertarian principles but we also want transparency which is the polar opposite of a Libertarian true free market.

    so I can never tell which way Jim is thinking..!!!

    which is it?

    do you want the govt to require transparency or do you want a Libertarian free market for health care ?

    I’m getting whiplash here!

    1. I want a functional free market for health care. Public availability of information is one important component of creating a free market. Ergo, making more data available, especially when it is directly relevant to patient/consumers, will help move our dysfunctional health care system toward a more market-based system. Much else is needed, of course, but transparency is one of the key elements. If you have whiplash, you probably got it from driving your car — not reading the blog!

      1. LarrytheG Avatar

        isn’t govt-mandated transparency for the private sector very UN Libertarian?

        how can you have a true free market if the govt is controlling it?

  2. Good luck with that! I have suggested a number of other stats that would be very telling on the State Medical Board and Va. Dept. of Health Professions. I always get the finger, and even with FOIA they will ignore it.

    1. I don’t expect that the Virginia Department of Health will release sensitive information just to make Jim Bacon or Vic Nichols happy. We have to create a movement. Only when enough people clamor for transparency will we get it. We have to keep up the noise. Maybe we need to organize a march!

      1. LarrytheG Avatar

        but you guys are advocating for the government to force private sector companies to do something they would never do in a true free market!!

        1. Larry, you persist in the puerile notion that Libertarians believe in a pure laissez-faire society with no government involvement in the economy. A few Libertarians actually believe that. I don’t.

          In the world we live in — not the one we want, but the one we live in — government is involved in everything. Government intrusion in the marketplace is arguable the worst of any sector of the economy. Government bolloxed it up, and some government intervention will be necessary to un-bollox it.

          1. LarrytheG Avatar

            you stand and fight for your principles though , right?

            Otherwise I can call myself a Libertarian also – just different from you since we both don’t subscribe to pure Libertarian principles.

            re: govt bollixed it

            Bullfeathers !!! in a REAL free market there is NO govt-mandated transparency.

            you’re saying in YOUR faux-libertarian world – there is then you give this bogus excuse.. take the govt out of it. what happens?

            is there a realistic expectation that businesses will be transparent?

            In the countries in the world with the least govt and the most free markets – there is NO transparency. You blame that on govt also?

            come on guy.. you’re weaseling here…

            take an honorable position!

          2. djrippert Avatar

            Transparency is critical to the Libertarian philosophy. Take audited financial statements for example. The government requires all publicly traded companies to publish extensive financial statements audited by a certified independent accounting company. Because of this I don’t need any more government regulation regarding when, where, how and in what I invest my money. Since I can rely on the assertion of the company I don’t need the Mommy state protecting me from myself.

  3. LarrytheG Avatar

    Jim – I hate to break it to you guy – but LIBERALS are the ones that support the govt forcing the free market to be transparent.

    There is no if, ands, or butts about it… it’s the antithesis of Libertarianism.

    come on guy – admit it!!!

    1. Talk about free market transparency and government interference? I have to break it to YOU, LG, it was that damned Republican, TR, who got our basic anti-trust framework through Congress.

      1. LarrytheG Avatar

        @Acbar – TR today would be classified as a Liberal!!

    2. djrippert Avatar

      When a group of miscreant businessmen ran amok under the Clinton Administration it became George Bush’s job to mete out the punishment. He sent them to jail. When a group of miscreant bankers ran amok under Bush it became Obama’s job to mete out the punishment. He fined their shareholders and then gave them Hillary and Bill Clinton’s basement e-mail address so they could hire Mr and Mrs RICO violation to give speeches at hundreds of thousands of dollars a pop.

      No wonder Obama is in such a sour mood lately. No doubt he was expecting President Hillary Clinton to return the favor and send the un-incarcerated banksters his secret e-mail address!

  4. LarrytheG Avatar

    re: ” Transparency is critical to the Libertarian philosophy. ”

    so… what would make businesses be transparent on various measures that Jim is alluding to? Would they do that voluntarily?

    or your example.. investors want transparency but so do consumers.

    what causes companies to provide data like the number of deaths due to some flaw or for all companies to provide data in uniform standards so companies could be compared?

    I don’t see this happening without govt regulation – and as stated before -that’s a core principle of Libertarianism… and on this and other issues – it seems like Jim is choosing to be a “little” pregnant.

    Liberals want the transparency and they want it such that consumers can use it when choosing a product – and they want the data to not only be required but required so that it can be compared.

    Nutrition Labels? how many companies would voluntarily provide – uniform data on their products so they can be compared?

    Is this something Libertarians would support – i.e. Government forcing companies to reveal specific data like salt, sugar, fat, etc… on a standard label?

    Libertarians typically believe that transactions should be unfettered by government… go to their website… and see their positions!!!

    Jim says he’s a Libertarian at heart but he sure zigs and zags… through these issues! Not that long ago , he was asking why the govt allowed his insurance company to “jack up” his rates! GEEZE!

    He LIKES Uber but then he worries about Tesla selling cars “direct”.

    he’s all over the map on this Libertarian stuff!

  5. LarrytheG Avatar

    ” As I argued previously, Virginia consumers/patients should have full transparency into the risks they are taking when they enter a hospital. When I wrote previously, I was unaware that the Virginia Department of Health collected the data”

    This is incorrect – and it glosses over the fact that it is, in fact, Federal GOvt regulation that REQUIRED the collection of this data, after which it was published and made available to VDH.

    This regulation which Jim is calling for MORE OF in the title of this blog post: ” More Data on Hospital-Acquired Infections, Please”.

    Well you’d never know that by reading here and especially so if you read the other blog posts decrying liberals, leftists, and the incompetent and corrupt Federal govt imposing itself on the hapless innocent!

    I just would like Jim to ADMIT that this data that he loves and lavishes transparency and accountability PRAISE on is, in fact, the very Federal Govt regulation that he and fellow Conservatives and faux Libertarian rail about as they assert that the free market should be left to do.

    And it’s not just this blog post. It’s a neverending series of blog posts that alternate between blaming the govt for all sorts of “bad” , then the very next post.. just giddy wonderment of “big data” and “transparency” to hold the big bad government – accountable.

    Public Schools are condemned and castigated for their poor performance .. Cranky swings his axe to slay the VDOE and public schools trying to “hide” the “facts” . forced out by Federal regulation.. and then Bacon advocates voucher schools as a remedy – with no such equivalent standards of data collection!!!!

    I think Jim is more than entitled to his views but this schizophrenic relationship with govt and data collection – transparency and accountability needs a “tune up” !!!!

    Jim needs to forthrightly OWN his love of … Govt DATA and ADMIT IT when he is actually using that data to hold some entity “accountable”!!!

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