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Medicare Data Show Variation In ‘Central Line’ Infection Rates Across States

Across the country, one in six hospitals has high rates of one of the most serious kinds of preventable infections — those caused by catheters inserted into large veins, according to new data published by the Centers for Medicare & Medicaid Services.

Patients at hospitals in Maryland, Mississippi, Louisiana, Maine and New Hampshire were most likely to get blood infections caused by central lines, which are narrow tubes inserted in a major vein to inject medicine or fluids or to perform tests.

Hawaii, Alaska, South Dakota, Kansas and Indiana had the lowest rates, according to the data, which cover the first three months of 2011.

The Centers for Disease Control and Prevention, the source of the data CMS is publishing on its Hospital Compare website, says there were about 41,000 central-line associated bloodstream infections in 2009. A line that hasn’t been cleaned or is inserted incorrectly can lead to germs getting into a patient’s bloodstream.  CMS says treating these infections adds about $17,000 to a hospital stay.

About a fourth of the patients die from the infection, which should be preventable if hospitals follow cautionary guidelines.  As required by the 2010 federal health law, Medicare is gearing up to financially penalize hospitals with high rates of infections that are caused by the institutions.

The new data cover intensive care units at 1,146 hospitals. Medicare’s evaluation found 187 hospitals’ intensive care units with more central-line infections than institutions of a similar type and size. Another 386 hospitals had no central line infections during the first three months of last year, according to the data. CMS didn’t publish data for 2,232 hospitals, either because the hospital didn’t have an ICU unit or had too few or no cases to evaluate.

Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said hospitals welcomed the new data as more accurate than Medicare’s previous infection data, which came from bills hospitals submitted to Medicare. The new data include all patients, not just those covered by Medicare, and are based on medical records rather than bills.

Foster cautioned that the period covered by the data is short, just three months, so she said the information will become more reliable as it expands in the future. “We are very supportive of good quality information being up on Hospital Compare,” Foster said.

Below is the state by state breakdown, as calculated by CMS. The lower the score, the fewer central line infections there were.

Chart updated at 5:35 p.m. to correct the label on the data from Arkansas.

State Score
Maryland 0.91
Mississippi 0.89
Louisiana 0.87
Maine 0.85
New Hampshire 0.84
Arizona 0.79
South Carolina 0.77
Tennessee 0.77
Montana 0.73
Alabama 0.72
District of Columbia 0.72
New York 0.72
New Jersey 0.67
Kentucky 0.65
Vermont 0.63
Nevada 0.60
Virginia 0.60
Nebraska 0.59
Utah 0.59
Wisconsin 0.59
West Virginia 0.58
Colorado 0.56
Georgia 0.55
Idaho 0.55
North Carolina 0.55
California 0.53
Oregon 0.53
Texas 0.53
Oklahoma 0.52
Rhode Island 0.52
Iowa 0.51
North Dakota 0.51
Arkansas 0.49
Florida 0.49
Delaware 0.48
New Mexico 0.48
Ohio 0.48
Massachusetts 0.46
Wyoming 0.46
Missouri 0.44
Pennsylvania 0.44
Connecticut 0.43
Illinois 0.43
Minnesota 0.40
Washington 0.38
Michigan 0.36
Indiana 0.34
Kansas 0.30
South Dakota 0.28
Alaska 0.18
Hawaii 0.06
Source: Centers for Medicare & Medicaid Services

This article was produced by Kaiser Health News with support from
The SCAN Foundation