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Sebelius Challenges Hospitals to Reduce Health Care Associated Infections

By Melissa Attias, CQ Staff

May 8, 2009 – Following reports released by the Department of Health and Human Services indicating that patient safety measures have worsened, HHS Secretary Kathleen Sebelius this week challenged hospitals to reduce the number of health care associated infections (HAIs) in their facilities, according to an HHS news release.

HAIs drive up the cost of health care in the United States by up to $20 billion each year and are among the top ten leading causes of death, HHS said.

Sebelius called on hospitals to reduce the number of Central Line Associated Blood Stream Infections in intensive care units by 75 percent over the next three years, the release said. HHS also plans to make $50 million in grants available for states to fight HAIs using funds from the economic stimulus law, the release said.

"Healthcare-associated infections can make illnesses worse, further debilitate patients who are already struggling and sometimes lead to death," Sebelius said in the release. "Through the funding provided by the Recovery Act, we can help prevent these infections and improve the quality of care for all patients."

Yet according to the 2008 National Healthcare Quality Report published annually by the Agency for Healthcare Research and Quality (AHRQ), patient safety in the United States is not improving. The 2008 report shows nearly a 1 percent decline in patient safety since 2007.

In addition, the report showed that improvements in health care quality are unevenly spread across the difference settings of patient care. Although care delivered in hospitals has increased approximately 3 percent per year, for example, the report said that care in ambulatory settings only improved at a rate slightly more than 1 percent.

The amount of patients receiving needed care also varied widely across medical conditions, according to the report. Patients who are hospitalized with a heart attack receive 95 percent of recommended services, for example, while only 15 percent of patients on dialysis are registered on a kidney transplant waiting list, the report said.

Meanwhile, the 2008 National Healthcare Disparities Report also published by AHRQ showed that at least 60 percent of measures of quality of care are not improving for Blacks, Asians, American Indians/Alaska Natives, Hispanics and poor people. The proportion of new AIDS cases was 9.4 times as high for Blacks as for Whites and the rate of new AIDS cases was more than three times as high for Hispanics as for non-Hispanic Whites, the report said.

In addition, Asians were more likely than Whites to not get care for illness or injury as soon as they wanted and poor adults were more than twice as likely not to get timely care, the report said. The disparities report also showed that the percentage of children whose parents reported having trouble communicating with health care providers was almost four times as high for poor children as for high-income children. American Indian/Alaska Native women were also twice as likely to lack prenatal care as White women, the report added, while American Indian/Alaska Native adults were less likely than whites to receive colorectal cancer screening.

"Today's reports show why we can't wait to enact comprehensive health reform," Sebelius said in the release. "The status quo is unsustainable and we cannot allow millions of Americans to continue to go without the care they need and deserve."

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