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Hospital Acquired Infections -- How Does Massachusetts Stack Up?

Posted by John McDonough  February 12, 2012 12:19 PM

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New data from the federal Centers for Medicare and Medicaid Services shows that Massachusetts has the 14th lowest/best rate among the 50 states in the incidence of one of the most serious and deadly types of hospital acquired infections (HAIs).

Could be worse, could be better...

Kaiser News has a good summary here. In 2009, there were 41,000 central-line associated bloodstream infections (CLABSIs) in U.S. hospitals, according to the U.S. Centers for Disease Control and Prevention (CDC). These infections happen when narrow tubes are inserted in a major vein to inject medicine or fluids or to perform tests. Each one, according to CMS, adds about $17,000 in costs to a hospital stay, and about one fourth of patients who get the infection die from it. And, if hospitals follow recommended guidelines, the infection is almost entirely preventable.

As part of the Affordable Care Act (ACA/ObamaCare -- section 3008), hospitals with excessively high rates of preventable HAIs (e.g.: these infections) will soon face significant financial penalties from CMS. (Question to Mitt Romney: are you committed to repealing this part of the ACA, too?)

Here are rates from the best and worst performing states:

State Score
50. Maryland -- 0.91
49. Mississippi -- 0.89
48. Louisiana -- 0.87
47. Maine -- 0.85
46. New Hampshire -- 0.84
45. Arizona -- 0.79
44. South Carolina -- 0.77
43. Tennessee -- 0.77
42. Montana -- 0.73
41. Alabama -- 0.72
14. Massachusetts -- 0.46
13. Wyoming -- 0.46
12. Missouri -- 0.44
11. Pennsylvania -- 0.44
10. Connecticut -- 0.43
9.  Illinois -- 0.43
8.  Minnesota -- 0.40
7.  Washington -- 0.38
6.  Michigan -- 0.36
5.  Indiana -- 0.34
4.  Kansas -- 0.30
3.  South Dakota -- 0.28
2.  Alaska -- 0.18
1.  Hawaii -- 0.06
Source: Centers for Medicare & Medicaid Services

Out of 1,147 hospitals examined, Medicare found 187 hospital intensive care units with comparatively high rates while 386 hospitals had no central line infections during the first three months of last year. This survey covers only three months of data, so future analysis may show some shifts. And there are many hospitals for whom no data or only insufficient data were available. I looked up 31 in Greater Boston: 8 hospitals had better than expected rates (Boston Medical Center, Brigham & Women's, Lahey Clinic, Massachusetts General, Mount Auburn, St. Elizabeth's, South Shore, and Tufts) and 23 were N/A.

If you want a closer and better detailed look at Massachusetts hospitals, the place to go is the new report released last week by the Mass. Department of Public Health and available here: Health Care Associated Infections in Massachusetts Acute Hospitals, Second Public Report, covering 7/1/09 through 6/30/11.

Thanks to all of this attention, elimination of hospital infections is getting the kind of attention it needs. Not too long ago, the attitude was that infections were unavoidable and a fact of life. Dying from "hospital complications" was the norm and questions were not answered. Many, many patients lost their lives or had their lives irreparably harmed.

We're on a good path, and as all the data show, we still have a ways to go. Now is not the time to let up our guard; now is the time to hasten the progress. 

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »


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