California does not track deaths from hospital acquired infections (HAIs) and a newly proposed bill aims to change this. If passed, the bill will make it mandatory for physicians to record antibiotic-resistant infections on death certificates if the infections contributed to the death. In September 2016, a Reuters survey revealed that thousands of superbug deaths across the nation go unrecorded every year. As a dedicated provider of physician billing services, our company had reported on this issue in October 2016.
HAIs are omitted from death certificates, but medical billing records indicate what a patient was actually treated for. In 2014, University of Michigan researchers reported that HAIs would overtake heart disease and cancer as the leading causes of death in hospitals if the count was taken from the patients’ medical billing records instead of death certificates.
The goal of the new California bill is to establish the most comprehensive statewide surveillance system to track infections and deaths from drug-resistant pathogens. It would:
- require hospitals and clinical labs to submit an annual summary of antibiotic-resistant infections to the California Department of Health beginning July 1, 2018;
- change a law governing death certificates by requiring physicians to specify on death certificates when a superbug was the leading or a contributing cause of death
- require the state Health Department to publish an annual report on resistant infections and deaths, including data collected from death certificates
In 2013, the Centers for Disease Control and Prevention estimated that at least 23,000 people in the U.S. die every year from antibiotic-resistant infections. However, a Reuters analysis found that this estimate was mostly guesswork as they were based on very small samples.
Catheter-associated UTIs, surgical site infections, and ventilator-associated pneumonia are common hospital acquired conditions. HAIs also include specific infections like Methicillin-resistant Staphylococcus aureus (MRSA) and C. difficile, an infection which typically affects older adults in hospitals or in long-term care facilities, usually after antibiotic medication use.
Research suggests that most of these infections are preventable. Committed to preventing HAIs, The U.S. Department of Health and Human Services (HHS) established the Healthcare-Associated Infections objectives for Healthy People 2020. Ongoing efforts include: expanding implementation of strategies known to prevent HAIs, advancing development of effective prevention tools, and exploring new prevention approaches. It’s crucial that hospitals work to reach federal targets for hospital-acquired infections, failing which they will face payment reductions to Medicare discharges for a specified period. More and more insurers are adopting financial incentive programs to encourage hospitals to improve quality and safety with Pay for Performance models.