By one estimate, annual deaths from hospital-acquired infections have increased from 13,000 in the early 1990s to about 92,000 now. Patients are more susceptible to infections today because more of them have chronic illnesses and weakened immune systems. Some devices used in hospitals, like catheters, offer bacteria a foothold in the body. Hospital staff may not always take precautions like hand washing and changing catheters. Experts also worry that the widespread use of antibiotics to treat minor infections may increase the resistance of bacteria like Staphylococcus .
Normally, staph causes no symptoms. But in hospitals it can develop resistance to powerful antibiotics. Other bacteria have also started to develop such resistance–including Enterococcus (found in the colon)–which can make them especially lethal.
One study, using national hospital-discharge data to identify 20 “potential patient safety events,” found only small differences in safety among different types of hospitals. Compared with non-teaching hospitals, urban teaching hospitals had a slightly higher incidence of surgical tools left in during surgery, infection due to medical care, postoperative complications and birth-related complications. Some differences may reflect the fact that patients in teaching hospitals tend to be sicker. Compared with state-funded hospitals, for-profit hospitals had a higher incidence of anesthesia complications, skin ulcers, infection due to medical care, surgical tools left in during surgery and postoperative respiratory failure and infection, but the lowest incidence of birth-related complications.
There is a limited amount of publicly available information. The Leapfrog Group assesses whether a neonatal intensive-care unit has an average daily census of 15 or more. It’s based on the notion that a well-staffed, active and experienced NICU is a good marker of a hospital’s ability to provide safe care. Most women rely on word of mouth or select a hospital associated with an academic medical center.
