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Pennsylvania Becomes First State to Collect Data on Hospital-Acquired Infections

There have been an increasing number of reports of patients contracting infections while in the hospital. Several studies have estimated that between 1975 and 1995 the incidence of hospital-acquired infections per 1,000 bed days increased by 36.1 percent. That translates into approximately 2 million patients each year in the United States. It is estimated that these infections result in some 90,000 deaths.

In response to these frightening statistics, last year the Pennsylvania Health Care Cost Containment Council (PHC4) began collecting information on infections that patients contract while in the state's hospitals. It is one of the only state-based initiatives of its kind. In July, PHC4 released its first analysis of the data collected. The results are alarming and should serve as a wake-up call to hospitals around the country.

In 2004, there were slightly more than 1.5 million admissions to Pennsylvania's 173 general hospitals. These hospitals reported 11,668 hospital-acquired infections. Of these patients, 15.4 percent died, compared to a mortality rate of 2.4 percent for patients who did not have a hospital-acquired infection. Mortality rates were highest (31.9 percent) for patients with ventilator-associated pneumonia, followed by patients with central line-associated bloodstream infections (25.6 percent) and Foley catheter-associated urinary tract infections (9.4 percent).

In addition to pain and suffering, hospital-acquired infections contribute significantly to rising health-care costs. According to PHC4, in 2003 the average payment (to third-party insurance) for a hospital admission in which a patient contracted an infection was $29,320, compared to $8,319 for admissions that did not result in an infection.

As disturbing as these statistics are, PHC4 believes the numbers are actually much higher because of disparities among hospitals' data submissions. Several large hospitals submitted invalid data for the majority of their discharges and several others reported no hospital-acquired infections. Additionally, there were discrepancies between reported infections and the number of infections that were billed by the hospital. In order to better understand this discrepancy, PCH4 screened billing data and compared it to reported infections (see table).

The PCH4 report demonstrates how widespread and costly are hospital-acquired infections. Armed with this data, the state is now in a good position to put policies and practices in place that can minimize the risks associated with hospitalization and prevent the added burden that hospital-acquired infections place on patients and the health care system. We encourage other states to follow Pennsylvania's lead.

Actual and Possible Hospital-Acquired Infections

Type of Infection Hospital-Aqcuired
Infections (as reported
by hospitals)		 Possible Hospital-Acquired
Infections (as identified through
diagnosis screening process)
Patients with Infections 11,668 115,631*
Surgical Site 1,317 4,132
Urinary Tract 6,139 69,466
Pneumonia 1,335 32,090
Bloodstream 1,932 21,458
Multiple Infections 945 —
*The number of patients does not match the number of infections because some patients had more than one infection. In those instances each infection was counted once under each type of infection present.

Consequences of Hospital-Acquired Infections, Pennsylvania, 2004

Type of Infection

 Number of Hospital-Acquired Infections

Average Additional Length of Stay (in days) Per Patient

Mortality Rate (% died)

Average Additional Hospital Charges

Surgical Site

 1,317

 7.8

3.1

 $104 million

Urinary Tract

 6,139

 12.4

 9.4

 $472 million

Pneumonia

1,335

 N/A

31.9

 $427 million

Bloodstream

 1,932

  26

25.6

 $609 million

Multiple Infections

  945

N/A

N/A

  $388 million

Total

 11,668

205,000

15.4

$2 billion


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