The UVa medical center has focused in recent years in bringing down the rate of deaths from surgical complications.
Here’s the good news: 75 fewer people have died from surgical complications at the University of Virginia Medical Center so far this year than last year.
Here’s the bad news: The public doesn’t know how many people did die from surgical complications.
UVa assuredly knows, but the figure did not appear in a Daily Progress article on the subject, presumably because hospital administrators did not care to share it.
Whatever the number, it was high enough to warrant recognition of the federal government. The hospital had higher-than-average death rates from surgical complications from 2013 to 2015, according to Centers for Medicare and Medicaid Services (CMS) data. The UVa hospital has been punished for the third consecutive year for high rates of hospital-acquired infections and other medical complications. As a result, the facility will receive an estimated $1.8 million less in Medicaid reimbursements this fiscal year.
UVa officials said that the hospital has launched a turn-around effort and that their data show big improvements, even if gains are not reflected yet in government data. “We are three years into a major transformation,” said Dr. Tracey Hoke, chief of quality and performance improvement at UVa. “It takes time for these efforts to be borne out in the national benchmarking services.”
Bacon’s bottom line: I’m not singling out UVa for special attention. I focus on UVa only because the Daily Progress happened to write about it. But it strikes me that the number of fatalities due to “surgical complications” is critical data that the public has a right to know. That data should be reported by every hospital in Virginia.
The fact is, hospitals are dangerous places. You don’t want to go into one unless you’re really sick. According to the Centers for Disease Control and Prevention, on any given day, about one in 25 hospital patients acquires at least one healthcare-associated infection. In 2011, the most recent data reported, there were 722,000 hospital-acquired infections (HAIs); 75,000 patients with HAIs died during their hospitalization.
(The Daily Press refers to “surgical complications.” Could that also include medical malpractice? Between 2005 and 2015 there were roughly 450,000 medical malpractice payments and adverse actions taken nationally against health care providers, according to the National Practitioner Database.)
The idea of reporting mortality rates generally for hospitals is controversial because some institutions — UVa is probably among them — get handed the hardest of the hard cases. It wouldn’t be fair to judge them based on mortality without adjusting for the acuity of the patients, which is exceedingly difficult to do in a manner that everyone agrees upon. But that logic doesn’t apply to hospital-acquired infections. That indicator reflects the quality of hospital management and medical practice. Before submitting to surgery at any given hospital, patients should know the odds of contracting a debilitating infection there.
Transparency is sorely lacking in the health-care sector, and Virginia’s hospital industry is no exception. Patients cannot function as effective consumers of health care services without this information. Hospitals already have the data, so it’s not as if government would impose some onerous and expensive new obligation to require them to gather it. Virginians should insist that data on hospital-acquired infections be made readily available to the media and the public.
Update: The UVa medical center isn’t the only institution with a problem. From today’s Roanoke Times: “The federal government will again dock Carilion Roanoke Memorial Hospital millions of dollars for having too many readmissions and hospital-acquired infections despite progress in lowering both rates.”