More states eye reporting infection rates to give scrutiny to hospitals

Some say examination may spur improvement; others caution that it could do more harm than good.

By Kevin B. O'Reilly, AMNews staff. April 16, 2007.

The movement to require hospitals and other health care organizations to report publicly how well they prevent nosocomial infections is spreading fast. Nine states are looking to join the 16 that have enacted such mandates in the past four years.

Bills in Georgia, Texas and Washington stand the best chance of passing this year, according to Lisa McGiffert, director of Consumers Union's Stop Hospital Infections Campaign. The group has written model legislation on hospital-acquired infections and is leading the push to mandate public reporting. Arkansas, Delaware, Massachusetts, Michigan, Minnesota and New Jersey also are considering legislation. But even as the pressure for more transparency builds, there is debate about whether public reporting is the best way to proceed.

Consumer groups, infection control professionals and many patient safety experts argue that the harsh light of transparency will spur doctors and hospitals to implement system changes that will greatly reduce health care-associated infections. Others worry that current measurement methods allow for too much subjectivity and that transparency could encourage groups to divert attention from improving safety to gaming the numbers.

The hard data that could determine which side has the upper hand in this argument are still trickling in. Three states -- Florida, Missouri and Pennsylvania -- have issued their first public reports of hospital performance on ventilator-associated pneumonia and surgical site, urinary tract and bloodstream infections. Most other states with mandated reporting are still in the two-year window between legislative enactment and the beginning of public disclosure established so state agencies have time to set out compliance rules and test reporting systems.