Hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) should never happen, if only hospital workers practiced rigorous hygiene, writes former New York lieutenant governor Betsy McCaughey. In fact, “for most infections, the only acceptable rate is zero.”

Litigation over such infections, she predicts, “will cause the next wave of class-action lawsuits, bigger than the litigation over asbestos.”

In the meantime, Medicare will stop reimbursing hospitals for the treatment of certain infections, and hospitals will also be barred from billing patients.

“The evidence justifying Medicare’s new policy is compelling,” McCaughey writes. Beth Israel Medical Center in New York City has gone 1,000 days without a central line bloodstream infection in the cardiac care unit. The key was spending $30,000 to implement a checklist that doctors and nurses must follow. This is claimed to have saved $1.5 million in treatment costs, and priceless lives.

Other hospitals have also reached the goal of zero central line infections. “We have the knowledge to prevent infections. What has been lacking is the will” (Wall St J). 8/14/08

Blue Cross/Blue Shield and other insurers will follow the lead of Medicare in refusing to pay for a lengthening list of “never events,” including catheter-related urinary infections, hospital injuries, bedsores, and severe post-operative chest infections (Kansas City Star 7/16/08).

“What will happen, of course,” writes Dr. Lawrence Huntoon, “is that hospitals will implement protocols to test for bedsores, minor cognitive deficits, and infections on admission.” The threshold for identifying these conditions will be very low. It is likely that the cost of the testing will far outweigh any savings to insurers from refusal to pay for treating hospital-acquired conditions. “In essence, hospitals will assure that ‘never’ events don’t occur—on paper.”

Additional information:

• “Medicare Changing Rules for Hospital Payments,” AAPS News of the Day 12/17/07.