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Tucson, Arizona | Published: 10.31.2007
PHOENIX — The state's top health official is weighing whether to force hospitals to disclose how often patients get infections, including from the new MRSA "superbug" bacteria.
But just because the state collects the information doesn't necessarily mean it will reveal it to the public or potential patients, said Susan Gerard, director of the Department of Health Services.
Gerard said Tuesday she's not convinced making hospital infection rates public helps promote patient safety. She said most patients don't get to choose where they are hospitalized, and even those who do probably wouldn't look up the information ahead of time.
More than half of all states have some sort of requirements for hospitals to report problems that develop with patients, Gerard said, adding the issue has taken on greater urgency with the emergence of new strains of bacteria that do not respond to traditional treatments, most notably methicillin-resistant staphylococcus aureus.
Any plan to make infection information public will get scrutiny — and possible opposition — from the Arizona Hospital and Healthcare Association.
"We understand the public concern over MRSA and other infections that are out there," said John Rivers, president of the organization. "We understand our need to respond to it responsibly and professionally."
But Rivers said there is a fear hospitals might be tagged for infections that are not their fault.
"It's very, very difficult to know whether the patient got that infection while he or she was in the hospital, whether it was brought into the hospital by that patient, whether the patient got the infection from a family member or other person outside the institution," he said.
But at least with MRSA, that's not an issue, Gerard said.
She said "community-acquired MRSA" usually shows up as a skin infection.
"A hospital-acquired one kind of gets into your bone, into your blood system, into your organs," she said. Gerard said while "it's still the same superbug" it is a "totally different kind of infection."
The Department of Health Services is sending detailed information about the bug to health-care providers.
According to health officials, MRSA infections occur most frequently among those in hospitals and nursing homes as well as those at dialysis facilities. But Gerard said she has doubts that knowing the infection rates will help people make more-informed choices.
"If you're in a car accident you don't usually get to choose where you're going," she said. "And then there's a whole lot of others of us who don't get to choose where we're going because our insurance company dictates where we can go."
Besides, Gerard said, she's found that people don't usually look up information already publicly available about their doctors until after they've had a "bad outcome." She said it's human nature, pointing to the Registrar of Contractors where, similarly, queries are made only after the roof starts to leak.
She also said a facility that treats many burn victims, who are easily susceptible to infection, is more likely to show a higher rate than a community hospital dealing mostly with auto accidents.
On Tuesday the agency issued new guidelines to help people avoid the "community-acquired" disease and to prevent public panic.
Rebecca Sunenshine, deputy state epidemiologist, said the bacteria is spread primarily by touching others who already are infected. She said that makes things like regular hand washing with soap or hand sanitizer "essential in facilities where people work, live and play close together."
The state has sent information to school administrators about the disease, including how routine cleaning procedures should be enough to help keep it from spreading. The advisory also said students who have skin infections with MRSA can attend school as long as the wound is covered with a clean, dry dressing and they are receiving proper treatment.
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