Progress Lags in Infection Prevention and Health Disparities

Little progress has been made in eliminating health care–associated infections (HAIs), according to the 2009 National Healthcare Quality Report and the National Healthcare Disparities Report recently issued by the Department of Health and Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ).¹

Of the 5 types of HAIs tracked in the reports, there were increases in the rates of postoperative sepsis (8%), catheter-associated urinary tract infections (3.6%), and other select infections caused by medical care (1.6%). There was no change in the number of bloodstream infections associated with central venous catheter placements. On a positive note, the rate of postoperative pneumonia declined 12%. Compared with white persons, blacks, Hispanics, and American Indians were less likely to receive preventive antibiotics before surgery in a timely manner.

“Despite promising improvements in a few areas of health care, we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access,” said AHRQ Director Carolyn M. Clancy, MD, in a release. “Targeted AHRQ-funded research in Michigan has shown that infection rates of HAIs can be radically reduced. We are now working to make sure that happens in all hospitals.”

According to the 2009 National Healthcare Disparities Report, uninsured Americans are less likely than those with private insurance to obtain recommended care, especially preventive services. In addition, disparities related to ethnicity, income, and education remain large. The report also stated that among the most prevailing disparity was the lack of preventive care. For example, many minorities had worsening disparities in the percentage of adults older than 50 years who received appropriate screening for colon cancer. Also, the death rate for colon cancer has increased for African Americans and Hispanic persons.

HHS Secretary Kathleen Sebelius said of the new reports, “[The] reports demonstrate why passing health reform was so critical. In 2009, health care–associated infections increased and minorities were less likely to have insurance and less likely to get the treatments they needed. In a reformed system, more Americans will get the care they need, regardless of their race or ethnicity, and the quality of care will improve. The numbers we saw today are troubling, but ultimately, reform will help turn these numbers around.”

Sebelius believes that the new health care reform law ensures that Americans have access to the free preventive services they need to create a system that prevents diseases before they require more costly treatment.

References:

Reference
1. Agency for Healthcare Research and Quality. Annual quality and disparities reports include data on rates of health care-associated infections, obesity and health Insurance. http://www.ahrq.gov/news/press/pr2010/qrdr09pr.htm. Published April 13, 2010. Accessed April 15, 2010.