Hospital Infections Not Curbed By Medicare Penalties: Study

New Medicare penalties have not been enough to curb the rates of certain hospital infections, according to the findings of new research.

A study published in the current issue of the The New England Journal of Medicine examined data from nearly 400 hospitals and health care systems in the National Health Care Safety Network between January 2006 through March of 2011.

Researchers found no decrease in the incidence of certain hospital-acquired infections, despite a recent decision by the Centers for Medicare and Medicaid services (CMS) to discontinue payments for these conditions.

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The study examined changes in trends of healthcare associated infections affected by the CMS policy, specifically involving central-catheter bloodstream infections and catheter urinary tract infections. These infections were examined against ventilator pneumonia, an infection not targeted by the policy.

There was no significant evidence found in the study to suggest that there was any impact on the infection rates at hospitals through the policy, which reduces payments for such infections. There were no significant changes in quarterly rates of infections of either catheter associated bloodstream infections or catheter associated urinary tract infections.

The data revealed a decreasing trend in all three types of infections before the implementation of the policy.

The Medicare policy change was implemented in 2008, in hopes of reducing these types of preventable hospital infections by reducing payments for catheter associated bloodstream and urinary tract infections. The federally mandated policy hoped to guard against additional payments to hospitals for treatment of these infections.

A central line bloodstream catheter is a tube that is inserted into large veins in the neck, chest or groin to administer medication or to collect blood from patients. These catheters are different from standard intravenous catheters (IVs), because they access a major vein close to the heart and stay in place for weeks, sometimes months, at a time. Because of this, central line catheters more commonly cause infection.

Catheter urinary tract infections occur after a catheter has been inserted into the bladder through the urethra to drain urine. This typically happens after prolonged use of a urinary catheter. Approximately 75% of urinary tract infections (UTIs) are associated with a urinary catheter, according to the U.S. Centers for Disease Control and Prevention (CDC).

More than 2 million hospital infections and 1.5 million nursing home and long term care infections occur each year, according to the CDC.

In recent years, an increasing number of medical malpractice lawsuits over hospital infections are being filed, as many experts believe that these infections can be prevented with the exercise of reasonable care.

According to prior research, preventable hospital infections cost the U.S. Economy nearly $19.5 billion in 2008 and claimed more than 2,500 lives that year.

Implementation of simple procedures, such as more frequent hand washing for healthcare professionals, timely removal of catheters deterring prolonged use and thorough instrument and patient room cleaning are widely recognized steps that can prevent many of these hospital infection problems.


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