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Hospitals must eliminate preventable infections

In his State of the Union message last month, President Bush warned that health care costs threaten the nation's economic competitiveness. If the president is looking for ways to save money on health care, here's a lifesaving way to do it: Call on hospitals to eliminate the large number of preventable infections.

Infections that have been nearly eradicated in some countries are raging through American hospitals. Hygiene is so inadequate in many hospitals that one out of every 20 patients contracts an infection. The danger is worsening because these infections often cannot be cured with common antibiotics. In 1974, 2 percent of Staphylococcus aureus infections were methicillin-resistant (or MRSA). By 2003, that figure had soared to an alarming 57 percent and is still rising.

Denmark, Holland and Finland once faced similar rates but brought them down below 1 percent. How? Rigorous hand hygiene, meticulous cleaning of equipment and rooms in between patient use, testing incoming patients to identify those carrying MRSA and other bacteria, and taking precautions to prevent the spread of these bacteria on gloves, hands, clothing, equipment and furniture.

Can all hospitals afford to take these more rigorous precautions? They can't afford not to. Hospital infections add an estimated $30.5 billion a year to the nation's hospital costs alone. That's $30.5 billion, enough to pay for the entire Medicare prescription drug program in 2006.

The human and financial costs of hospital infections are staggering, yet the federal government is exacerbating the problem. The federal Centers for Disease Control and Prevention is the chief culprit.

Numerous studies show that bacteria spread from patient to patient up to 15 times as fast under standard CDC precautions as under the more rigorous precautions used in other countries and in the few hospitals here that are eradicating infections. Yet the CDC has delayed advocating these rigorous precautions. Every year of delay is costing thousands of lives and billions of dollars.

Even worse, the CDC goes along with the hospital industry's demands for secrecy. The agency collects infection data from hundreds of hospitals across the nation but does not reveal data on individual hospitals. Seven states have passed laws to provide the public with hospital infection report cards, and 30 more states are considering similar legislation. Why? Because if you have to be hospitalized, you should be able to find out which hospital in your own area has the worst infection problem. Bush and Congress should instruct the CDC to get behind public reporting.

What more can the president do? Use Medicare's clout in the medical marketplace to motivate hospitals to prevent infections. Generally speaking, Medicare pays the same fees to hospitals with the best care as it does to those with high infection rates. Bush should tell Medicare to draw the line at paying hospitals with high infection rates. Hospitals will not improve until their biggest customer, Medicare, demands it.

Former Lt. Gov. Betsy McCaughey, Ph.D., is chairman of the Committee to Reduce Infection Deaths.

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