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Can Hospital Infections Wait?

Hospitals can cause deaths unrelated to your reason for being treated there. Infections contracted in the hospital in one year total 2 million people, result in 100,000 deaths and cost about $30 billion a year.  As many as 1 in 10 patients hospitalized in the U.S. will come down with an infection  Unfortunately, the Patient Protection and Affordable Care Act,  passed earlier this year, does nothing about this until 2015.  Even more importantly, will the measures proposed in the bill solve the problem?

Conditions For Infections To Occur

1.) The presence of harmful bacteria
These exist everywhere but are especially prevalent in hospitals.
2.) A way for the bacteria to spread
In hospitals, this occurs must often when hands aren’t washed between patients or gloves and protective clothing aren’t worn during procedures.
3.) A person who is susceptible
Such people would include the elderly, the chronically ill,  those with generally poor health and individuals undergoing an invasive procedure like surgery or having a catheter inserted.

Some Common Hospital-Acquired Infections

Urinary tract infections are the  most common type, accounting for 40% of all health care associated infections.  Four out of five urinary track infections are associated with the presence of a catheter, a tube placed in the body to collect urine when a person cannot get out of bed.  Catheterization is often necessary  but the longer the catheter is in place, the greater the chances of infection.

Another particularly pernicious form of infection is Methicillin-resistant Staphylococcus aureus   or MRSA.  Although the common staph infection (Staphylococcus aureus) has been causing infections as long as the human race has existed, MRSA has a relatively short history. The increased use of antibiotics in recent years has led to the evolution of antibiotic-resistant MRSA strains. This dangerous infection often starts out as a skin affliction and then spreads to other organs in the body where it becomes life-threatening.

Clostridium difficile. (C.diff) is a very hardy bug that lives a long time and survives on difficult to sterilize surfaces like clothing.    It causes diarrhea, constipation, pain and flu like symptoms.  What makes it a common infection is that it normally resides in the body but becomes over populated and dangerous when antibiotics kill the good bacteria that keep it in check.

The Future of Infection Prevention

Acquiring an infection while undergoing health treatments doesn’t need to happen as often as it does.  30-50% of these infectious incidents can be prevented by assiduous hand washing between patients, wearing disposable protective gloves, masks and gowns when contact with any bodily fluid is likely and limiting the use of catheters as much as possible  Unfortunately, even though these facts are irrefutable, measures to ensure these precautions are difficult to enforce and, as a result, the infection problem is worsening

Despite this, it won’t be until 2015 that Health and Human Services (HHS) addresses this very serious problem.  Then, according to the Patient Protection and Affordable Care Act,  HHS will start reporting each hospital’s record for infections.  Those with the highest rates will be penalized with a 1% reduction of their Medicare payments.  Will this turn things around?  Recent history says no.  In 2007,  Medicare stopped paying hospitals for treatments of secondary conditions not present at admission.  This did not lower infection rates.  Will publishing hospital infection rates have an effect?  Possibly but the bigger question is why isn’t this a higher priority with HHS??

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