A Consumer Reports (CR) study recommends the federal government require hospitals to report infection outbreaks immediately, undergo inspections of their infection-control programs, and establish a system for patients to report their own infections to improve tracking.
CR investigated hospitals’ track record on reducing infections contracted through a central line, such as an IV inserted into a large vein near the neck or heart, focusing on the results of teaching hospitals, according to the study published in the January 2017 issue of Consumer Reports.
“About 650,000 people developed infections after being admitted to U.S. hospitals in 2011, and 75,000 died, based on the most recent data from the Centers for Disease Control and Prevention,” the analysis states. “Central-line infections account for roughly 5 percent of all hospital-acquired infections, striking more than 27,000 people in 2015, research shows.”
States with the best track records are Hawaii, Kansas, Minnesota, Oregon, and Wisconsin, according to the report’s map. The lowest-ranking states, except for New Mexico, are clustered in the South: Alabama, Arkansas, Louisiana, and Mississippi.
Evidence, or Intention?
Dr. Brian Sachs, a family physician and hospitalist in Hamlet, North Carolina, says adding to existing federal reporting requirements for hospitals won’t reduce central-line infections.
“It seems Consumer Reports hasn’t done their homework,” Sachs said. “Have they never heard of Joint Commission accreditation, state licensing requirements, and Medicare certification?”
Ratcheting up reporting requirements would be a kneejerk reaction to the CR study, ignoring the failure of federal reporting mandates to stop infections, Sachs says.
“While the medical profession continues to strive toward evidence-based diagnosis and treatment of disease, our governing bodies continue headstrong implementing intention-based policy without regard to any evidence of effectiveness of these policies,” Sachs said.
Task for States, Markets
Instead of punting the burden of hospital oversight to the federal government, states should improve their own accountability systems, Sachs says.
“If Consumer Reports believes state agencies are not doing enough to monitor central-line infections, they should clarify exactly how their reporting measures fail,” Sachs said.
“The issues listed in the report indict existing regulatory agencies as incompetent or worse, not needing more muscle,” Smith said. “Reporting dangerous conditions could be a contractual condition that must be satisfied in order to retain the approval stamp of a private inspection firm, many of which should be operational.”
Government mandates exacerbate problems only free markets can fix, Smith says.
“The issues they are attempting to address are the result of a lack of competition in the marketplace and are, therefore, downstream problems created by the government agencies ostensibly instituted to keep us safe,” Smith said.
Reducing government’s role in overseeing hospitals would make room for market-based oversight aligned with provider incentives to impress patients.
“In a free market, medical facilities should not only post their infection rates but [also] their prices,” Smith said. “Just as any electrical appliance has ‘UL’ stamped on it to alert the buyer [of the company UL’s approval], the market should be enabled to create private agencies, an approval stamp from which should provide reassurance to the buyer and patient.”
Sachs says lawmakers should resist the urge to regulate now and reason later.
“We need to approach public policy the same way we do medicine: with evidence of effectiveness,” Sachs said. “It is time to stop passing legislation simply because it sounds like a good idea. Health care knows all too well the unintended consequences of ‘well-intentioned’ legislation.”
Christina Thielst ([email protected]) writes from Santa Barbara, California.
Christina Thielst, “Study Identifying Medical Error As a Leading Cause of Death Under Criticism,” Health Care News, The Heartland Institute, June 2, 2016: https://heartland.org/news-opinion/news/study-identifying-medical-error-as-a-leading-cause-of-death-under-criticism
John Dale Dunn, “The Myths of Managing Health Care,” American Thinker, April 11, 2010: https://heartland.org/policy-documents/myths-managing-health-care.
John Dale Dunn, “Patient Safety in America: Comparison and Analysis of National and Texas Patient Safety Research,” Texas Medicine, Texas Medical Association, October 2000: https://heartland.org/policy-documents/patient-safety-america-comparison-and-analysis-national-and-texas-patient-safety-re.
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