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Sunday, October 14, 2007

Ind. Law - Calif. Gov. Schwarzenegger kills a bill that would have required infection and death rates to be made public; what about Indiana?

The LA Times reports today:

SACRAMENTO -- Under pressure from the politically robust hospital industry, Gov. Arnold Schwarzenegger has rebuffed a legislative proposal that could help California catch up with other parts of the nation by allowing patients to learn the safety and surgical success rates of specific hospitals and doctors.

Healthcare experts say that one of the most inexpensive and effective ways to encourage hospitals to improve patient care is to make their failures public. Schwarzenegger has endorsed this approach, saying as recently as March that greater transparency would "drive healthcare providers to perform at peak levels," "boost the power of consumer choices," "save a lot of money" and "save a lot of lives."

But the governor on Friday vetoed a bill passed by the Legislature that contained provisions that would have made it easier for the public to review hospital performance. * * *

The proposal does not require the state to release any information to the public, leaving those decisions to the discretion of the governor. * * *

More than two decades after the state started collecting data from hospitals, the state's performance continues to be less than inspiring.

California has issued studies on how hospitals handle just two conditions -- heart attacks and pneumonia -- and one operation -- coronary artery bypass grafts -- even though a 1980s law requires the state to complete at least nine reports each year. * * *

Other states, including New Jersey, Kentucky, Missouri and Maryland, are doing more. Last month, New York City began releasing annual infection and death rates at the city's 11 public hospitals.

Healthcare experts say Pennsylvania does the best job, reporting each year how effectively its hospitals treat 19 common ailments, including blood clots, heart and kidney failure and strokes.

Pennsylvania also publishes data showing how well its hospitals repaired hip fractures, unblocked seized-up hearts and performed 10 other procedures.

California is particularly far behind other states in compelling hospitals to reveal how likely patients are to contract an infection while in a hospital. Prodded by Consumers Union, a nonprofit advocacy group, lawmakers in 19 other states have mandated that hospitals release that data.

Federal officials estimate that healthcare-associated infections lead to 99,000 deaths each year, making them one of the biggest killers in the United States. Infections have grown so costly to Medicare, the nation's insurance program for the elderly, that starting next year the government will cease reimbursing hospitals for the cost of treating infections that patients pick up there.

What about Indiana?

Hospital infection rates and death rates are what consumers need to see. This most recent ILB entry, from March 6th, 2007, reporting on a press conference by the Governor and State Health Commissioner, says nothing about either hospital infection rates or death rates.

The Indiana State Board of Health (ISBH) Hospital Consumer Reports Search Page does not, as far as the ILB can determine, using its Hospital Quality Alliance Quality Measures, give either infection rates or death rates by Indiana hospital. Rather, it gives preventive care measures - how often did the hospital give aspirin to a heart attack patient, etc?

The ILB finds the ISBH pages confusing and even maddening to try to use. At one point the ILB seemed to find some information on overall Indiana hospital mortality rates, but it took many minutes to relocate it . Here is the page. As it turned out, the Indiana page links without notice to a federal HHS page, not an Indiana page, and provides no information about Indiana hospital mortality rates.

And the ILB was able to locate nothing about Indiana hospital infection rates. So, unless someone can point the ILB elsewhere, it appears that Indiana is in the same position as California insofar as NOT providing the most essential information consumers need to know about Indiana hospitals - infection and death rates.

Consumers Union has been leading the efforts to make this information available to the public. See this press release from March 8th, 2007 for much useful information, including this chart of 2007 Legislative Session Hospital-acquired infection public reporting bills. It includes this information about Indiana bills in the 2007 session:

Indiana – HB 1592; SB 513; SB 531
Bill Status: All bills failed to pass before crossover deadline.
Bill Sponsor(s): HB 1592: Rep. Dvorak; SB 513: Sen. Alting; SB 531: Sen. Dillon
Other Information: HB1592 and SB513 require public reporting of hospital infection rates. SB 531 allows for a committee and agency to determine what infection information should be reported.

Posted by Marcia Oddi on October 14, 2007 08:41 AM
Posted to Indiana Law