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Only 14 states post hospital data on surgical site infections

The movement to use state-level public reports to spur safety improvements has slowed.

By — Posted April 2, 2012

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Less than half of U.S. states require hospitals to report surgical site infections, and only a fraction of these states have publicly posted the information for patients to use in deciding where to seek care, said a study published online March 2 in the Journal for Healthcare Quality.

Twenty-one states require reporting of infections acquired during surgical procedures such as coronary artery bypass grafts and hip and knee replacements. Only 14 of these states have so far posted any of the information publicly. Moreover, states differ on data collection procedures and risk-adjustment standards.

“I think the states slowed down their [public reporting] efforts because people assumed that this is a cause that’s going to be taken on by Medicare,” said Martin A. Makary, MD, MPH, the study’s lead author. “Medicare’s made some steps, but they are so small and incremental that they’re not really influencing consumer choices about where to go for medical care.”

In January 2012, hospitals were required to start reporting surgical site infections for hysterectomies and colectomies to the federal government. That information will be posted within the year to the Centers for Medicare & Medicaid Services’ Hospital Compare website. But Dr. Makary said that publicly reporting infections for a sliver of all surgeries could mislead patients and divert quality initiatives.

“A lot of attention to a select few procedures disproportionately pulls hospital resources to emphasize improvement on those publicly reported items at the expense of other important quality improvement initiatives and needs at a hospital,” said Dr. Makary, associate professor of surgery at Johns Hopkins University School of Medicine in Baltimore and author of the forthcoming book Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care.

So far, not much evidence has emerged to show that public reporting of quality data leads to a measurable improvement in patient outcomes. But public-reporting proponents argue that is because the transparency movement in health care has not advanced quickly and broadly enough.

Patients and health care quality would benefit from standardized, nationwide public reporting of more surgical site infections, said John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center.

“It is frustrating to see how long it takes our health system to step up to real accountability,” Dr. Santa said.

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ADDITIONAL INFORMATION

How states vary in public reporting of surgical infections

View in PDF

Click to see data in PDF.

Twenty-one states require hospitals to report surgical site infections, but only 14 states so far have posted the information publicly. (See correction)

States that
require reporting
Are data publicly
available?
AlabamaNo
CaliforniaYes
ColoradoYes
IllinoisYes
MassachusettsYes
MaineNo
MissouriYes
NevadaNo
New HampshireYes
New JerseyYes
New YorkYes
OhioYes
OklahomaNo
OregonYes
PennsylvaniaYes
Rhode IslandNo
South CarolinaYes
TennesseeNo
TexasNo
VermontYes
WashingtonYes

Sources: “Variation in Surgical Site Infection Monitoring and Reporting by State,” Journal for Healthcare Quality, March 2 (link); Consumers Union Safe Patient Project

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External links

“Variation in Surgical Site Infection Monitoring and Reporting by State,” Journal for Healthcare Quality, published online March 2 (link)

“State Disclosure Reports,” Consumers Union Safe Patient Project (link)

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Correction

The original version of this article incorrectly stated the number of states that have now published individual hospital rates of surgical site infections. American Medical News regrets the error.

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