As we discussed in our last post, the Centers for Medicare & Medicaid Services has just released its annual list of U.S. hospitals that will be penalized for having too many hospital-acquired illnesses and injuries occur. These 769 hospitals represent the bottom 25 percent of all hospitals studied and will be penalized by losing 1 percent of all Medicare payments for a year.
The full list is available from Kaiser Health News. Unfortunately, 41 New Mexico hospitals were in that bottom 25 percent, and three of those have been there in each of the three years studied so far: Presbyterian Hospital in Albuquerque, UNM Hospital in Albuquerque and the San Juan Regional Medical Center in Farmington.
Superbugs MRSA and C. diff spread easily when sanitary principles are disregarded
CMS added a new criterion this year as it compared hospitals on their rates of hospital-acquired conditions. Now, incidents involving MRSA and C. diff were taken into account. These so-called “superbugs” are a grave and growing concern because they are easy to pass along in healthcare settings and because they cannot be treated by antibiotics.
MRSA bacteria can be picked up and passed on from shaking hands or touching contaminated surfaces, and can even be carried by people who show no symptoms. Doctors, nurses and other healthcare professionals can combat the spread of MRSA through scrupulous hand washing. Hospitals can fight it only through meticulous attention to sanitary standards.
C. diff isn’t technically antibiotic-resistant. The problem is that antibiotics used to kill C. diff will also kill other bacteria in the digestive system, even the kinds we need. Complications range from serious diarrhea to the surgical removal of part of the intestine, or even death. C. diff, too, can easily be spread when allowed to linger on surfaces or when healthcare providers don’t wash hands between patients.
According to the CDC, at least 2 million people are infected with antibiotic-resistant bacteria every year, and nearly 250,000 of those infections occur in hospitals. Besides sharply reducing the use of antibiotics and increasing hand washing and sanitation compliance, epidemiologists say there isn’t much that can be done.
Does penalizing poorly performing hospitals improve patient safety?
It’s not entirely clear that the CMS penalty program reduces the rate of hospital-acquired conditions. Some experts consider it arbitrary, since a hospital could improve patient safety dramatically but might remain in the bottom 25 percent if other hospitals also improved.
Perhaps more concerning is each hospital has to decide how to fill the budget hole — which could be as much as a million dollars each year for a larger hospital. They may be forced to cut corners in other areas that also affect patient safety.