Debate: publicly reporting nosocomial infection rates

Over the past four years, 16 states – California, Colorado, Connecticut, Florida, Illinois, Maryland, Missouri, New Hampshire, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont and Virginia-have enacted legislation requiring hospitals to be transparent about how well they prevent hospital-acquired infections. Nine other states-Arkansas, Delaware, Georgia, Massachusetts, Michigan, Minnesota, New Jersey, Texas, and Washington-are considering joining the pack of 16.

The question is: Will public reporting of this data result in reduced infection rates? Since these mandates are fairly new (although the laws have been enacted, public disclosure is not yet required), it's too soon to tell. But the debate continues.

On the one hand, proponents of transparency believe that public disclosure will spur doctors and hospitals to make systematic changes to reduce infection rates. Just look at the successful impact state mandates for coronary artery bypass graft outcomes have had on Medicare's Hospital Compare measures, supporters say.

"We don't have any perfect system for doing [public infection reporting], but I think the good thing that is coming out of different states is we are learning how to do better," Denise Cardo, MD, director of the CDC's Division of Healthcare Quality Promotion, told American Medical News (4/16/2007).