Since 2014, hospitals across the U.S. have been evaluated on the basis of how many hospital-acquired conditions occur in their facilities. Each hospital is given a score based on patient safety indicators, the prevalence of infections acquired in the hospitals, and the presence of infection-resistant MRSA (Staphylococcus aureus) and Clostridium difficile.
The scores of the hospitals are then compared, and the worst-performing 25 percent are penalized financially. How? The agency will subtract 1 percent of every Medicare payment those hospitals receive. The government didn’t release exact dollar amounts assessed against these hospitals but, overall, Medicare will retain about $430 million. According to Kaiser Health News, many larger hospitals can expect to lose more than a million dollars due to the penalties.
What kinds of hospital-based harm are being found?
This program was put in place as part of the Affordable Care Act, also known as Obamacare. Its purpose is to compel hospitals to reduce the number of patients who are injured or sickened by incidents that typically only take place in hospitals. In other words, the patients came in for medical care and left suffering from a condition they could only have obtained through poor hospital care.
Common adverse events and hospital-acquired injuries considered in the report include:
- Bed sores and pressure ulcers
- Slip- or trip-and-fall accidents
- Reactions to hospital-prescribed medications
- Certain surgical and postoperative complications
- Central line-associated bloodstream infections
- Catheter-associated urinary tract infections
- Surgical site infections
There is good news in this area. According to the federal Agency for Healthcare Research and Quality, harm from hospital-acquired conditions dropped by 21 percent nationwide between 2010 and 2015. In human terms, unfortunately, that means 3.8 million people injured by hospitals last year — or 115 injuries per 1,000 inpatient hospitalizations.
Much more alarming are the data on hospital-acquired, antibiotic-resistant bacteria. The Centers for Disease Control and Prevention estimates that some 23,000 people die each year, primarily from MRSA and C. diff. Either of these can cause harm ranging from serious to deadly, and strains of each can resistant to all known antibiotics. Unfortunately, both can easily be spread from hand to hand until a contaminated healthcare worker touches a patient’s wound.
In our next post, we will discuss the urgent need to address antibiotic-resistant “superbugs” in our hospitals and the use of financial penalties to promote better patient safety outcomes.