Surgical site infection rates within the nation's hospitals are largely a secret, with public reporting required by only eight states, says a new Johns Hopkins University report, which calls for federal disclosure mandates so problem hospitals are better motivated to reduce preventable harm.
"There's a huge transparency problem within the entire industry of modern medicine," says Martin Makary, MD, a gastroenterology surgeon at Johns Hopkins University School of Medicine and the paper's lead author. "Patients by and large are still left with no useful information to make healthcare choices about which hospital to go to, and because of that fact, they don't have access to metrics that are being collected and they're forced to walk in blind."
The eight states that require public reporting are South Carolina, Missouri, Colorado, Massachusetts, New York, Ohio, Vermont and Oregon.
Of those eight, only South Carolina and Missouri require reporting on seven and five types of procedures, respectively, while the rest require reporting on four procedures or fewer. Although legislatures in 21 states require monitoring and reporting of infections, that data is not publicly available for the remaining 13. Twenty-nine states have no state reporting laws at all as of the date of the report, September of 2010, Makary says, and not much has changed since.
Makary adds that professional societies maintain risk-adjusted databases to collect hospital surgical infection rates, but they're listed without the hospital's name.
"Nothing motivates hospitals to improve quality and listen to their front line staff like public reporting," he says. "In order for the consumer to interpret publicly reported SSI rates, it is imperative that the data be collected and reported in a standardized manner," he and his co-authors wrote.