Hospitals Fined For Infection

June 17, 2016

High rate of infections or avoidable complications such as blood clots, bed sores or sepsis, will now have implications on how much money hospitals receive each year.

Medicare has restricted budgets to 758 hospitals in America, many of which are prestigious teaching hospitals. The ‘no messing’ attitude , comes from the federal government, highlighting the ever growing issue of patient safety in hospitals.

Many of the top hospitals argue this attitude and penalty is unfair. Surely it is the hospitals job to seek out infections and treat possible complications? This is showing they are doing their job and being vigilant. Not so, according to the federal government and Medicare, who say these issues should be avoided right from the start and have refused to reimburse hospitals for complications they have created.

This is all well and good, but studies have shown that even with these tough measures which have been in operation since 2014, the figure remains high of those going on to get a complication – 12 out of every 100 in fact.

Hospitals are losing 1% of their payments which on average affects budgets by $480,000, but in reality most academic centres will lose more than that because they have higher revenues. So the amount lost is significant.

Perhaps a little unfairly, even hospitals that are showing signs of improvement can still lose money, as the government require Medicare to fine one quarter of hospitals each year. Most hospitals that were fined in the current year, also received penalties for the previous year.

According to Medicare’s most recent data, Northwestern Hospital (also a teaching hospital) have an unusually high number of infections following colon surgeries, on average 1 in every 19 cases, as well as having a high proportion of blood clots. 1 in 260 intensive care patients with catheters, experience urinary tract infections. This rate is far higher than most other hospitals, even allowing for the fact that teaching hospitals tend to have more patient infections. As a result, Northwestern are set to lose $1.6 million this year.

In defence of the Northwestern Hospital, its director of the intensive care unit, Dr Richard Wunderink argues that the emphasis is all wrong. Reducing pneumonias in patients on ventilators is of paramount importance, but as it stands at the moment, this isn’t an area of penalty. More importance is being placed on the financial perspective, not the patient perspective. The hospital also has a much lower death rate than others, owing to their strict regime of lab testing for infections. The hospital argues that if you don’t look for infections, you won’t find them.

The federal government are reportedly concerned that staff have not been carrying out tests for the particular infections that would end in a penalty. Or were over testing on admittance, in an attempt to prove that the patient came into the hospital with an infection, not picked it up whilst being in there. Although the government urge people to whistle blow on such practices, it is entirely understandable as to why they’re happening. In addition to this, it also deters hospitals from taking on very sick patients.

So whether this whole initiative is a good idea, ensuring the best possible patient safety or is actually quite the contrary, will be determined in the coming months and years.

Posted in Uncategorised by Douglas Fahlbusch