One of the best ways to deal with the problem of antibiotic resistance is infection control in hospitals. That is, if patients aren’t getting infections, whether those be sensitive or resistant to antibiotics, then there’s less of a problem. Massachusetts has released its annual report on hospital infection rates. The report currently looks at two major causes of hospital acquired infections: central venous catheter blood stream infections (CLABSIs) and surgical site infections (SSIs).
The good news is that, compared to the nation as a whole, MA does no worse or even better than the national average. One issue is that many specific types of infections (catheter infections in pediatric ICUs) are very rare, so there’s limited power of test.
We’ll just have to bump up the sample sizes by infecting more people.
The other interesting thing to note is that the report is also broken down by individual hospital. Here too, sample size is an issue, especially for smaller hospitals, although, thankfully, no hospital seems to be doing worse than the national average (which given the sample size would be a disaster). And this has policy implications.
Betsy McCaughey (yes, the ‘death panel’ Betsy McCaughey) has argued that, to control hospital acquired infections, we need hospital reporting cards, and consumer choice will solve the problem (as opposed to TEH SOCIALISMZ!! which would involve regulatory penalties). Leaving aside the problems of controlling for patient populations, the Massachusetts data show that the report card idea is pretty useless due to statistical power problems.
If a hospital is having repeated problems, ‘consumer choice’ is not the solution. Forcing the hospital to fix these problems is.