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Source: pfala

The current recession has been one of the worst economic slumps in recent memory, and hospitals have been not been immune from the slump. Like many businesses today, hospitals have been cutting fixed costs as deeply as they can, and one of the casualties of this cost cutting is infection control, says a recent study from the Association for Professionals in Infection Control and Epidemiology (APIC).

The annual economic report surveyed more than 2,000 infection control specialists from around the country, mainly in acute care facilities, and found significant cuts and a lessening of support for infection prevention, even as state mandates increased their workload. More than 40% of the respondents reported significant cuts in budgets for infection prevention due to the recession over the last 18 months. The result has been reductions in staff, hiring freezes, and reduced hours as well as cuts in prevention education and technological upgrades (read the full report here). All these cuts suggest that many hospitals will have a reduced capacity to control the spread of HAIs, a fact that more than a third of the respondents acknowledged is already occurring.

The recent talk around Washington has been the need and possible mechanisms for controlling healthcare costs. One significant way is the prevention of hospital acquired infections, which significantly increase the costs of acute care stays. While state mandates on reporting are helpful, the mandates typically have no financing attached. Thus, hospitals have an incentive to cut their surveillance budgets, i.e. you can’t report what you can’t find. This pressure is only magnified in the current economy. And, with most state budgets in free-fall, enforcement is likely to be lax.

While pressure is mounting on lawmakers in Washington to “do something about healthcare,” there has been little talk of the need to control HAIs. However, with estimates that HAIs result in 99,000 deaths annually and add between $28 and $33 billion a year to the healthcare tab, it seems an area that should get more attention from both sides of the aisle. The solution, unlike seemingly everything else these days, does not require a bailout. What is needed is increased incentives for hospitals to do surveillance for and to manage HAIs, and regional integration to reduce the incentive for hospitals to free-ride off the efforts of other hospitals. Recent Medicare rules have decreased payments for HAIs, but these efforts, and efforts by private insurers, which have tried higher reimbursements for hospital with low HAI prevalence, must go further. Unfortunately, the recession is likely to make things worse in the foreseeable future.