In 28 states, hospitals are required by law to make a public report on at least some of the infections patients pick up while under the hospital's care.
Georgia is not one of those states, and patient advocates say that makes it difficult for consumers to make informed choices about where to go for health care.
"This should be something the state does for its consumers," said Holly Lang, director of the Hospital Accountability Project at Georgia Watch, a statewide consumer organization.
If restaurants must post their inspection scores on their walls, then hospitals should have to disclose rates of potentially deadly infections within their facilities, Lang said. That would help patients choose a hospital, she said, while also pressuring hospitals to improve patient safety.
"Your infection rate should not be your dirty little secret," Lang said.
Legislation to require reporting on infections at hospitals has been proposed in Georgia but not passed, said Pam Keene, a spokeswoman for the Georgia Department of Community Health.
"I think hospitals felt very defensive about releasing information because they felt it would be bad for their marketing," said state Rep. Pat Gardner, D-Atlanta.
But Gardner said that needs to change. "This is the age of consumer directed health care and if we want consumers to take a more active role in their health care, they need access to all kinds of information that is not currently available to them," she said.
Kevin Bloye, spokesman for the Georgia Hospital Association, said the state's hospitals are cautious about public reporting of infection and quality data because hospitals are still working to develop accurate systems for collecting such information that allows for fair comparisons. "More transparency is what the public wants and we're responsive to that," Bloye said. "But the key is making sure what we report is right and fair to each of the stakeholders involved."
Hospitals themselves crave better statistics because only through such measures can they accurately determine the best approaches to combating infections and other conditions, industry officials say.
Even though Georgia does not require public reporting, the state Department of Community Health (DCH) monitors infections and other conditions in Georgia hospitals and works with the Centers for Disease Control and Prevention to address any issues.
"The reality is that DCH is doing everything within its power to insure that health care facilities throughout Georgia are safe places to go," said Ryan Deal, director of communications at DCH.
A new federal database offers Georgians one source of information about the performance of the state's hospitals when it comes to infections. Medicare's "Hospital Acquired Conditions" data, published in April for the first time, reports rates of two types of infections and six other preventable conditions among Medicare patients. For the data see: www.hospitalcompare.hhs.gov .
Many hospitals criticize the data, saying it is based on imprecise billing information that is outdated and not adjusted to account for the varying condition of each hospital's patient population.
Most hospitals prefer an approach to data collection on infections overseen by the U.S. Centers for Disease Control and Prevention. Many Georgia hospitals voluntarily report data to that system already, but the information about individual hospitals is not open to inspection.
That is beginning to change under a new federal mandate. Most hospitals are now feeding data on s0-called "central line" bloodstream infections into the CDC's National Healthcare Safety Network, because of the mandate. But that information won't be made public until sometime next year. That program will also collect information on other types of infections, but publication of an array of measures in still years away.
Some Georgia hospitals closely guard their internal quality information. But others believe in sharing it.
Dr. Marcia Delk, chief quality officer at WellStar Health System, which runs five hospitals in Cobb, Douglas and Paulding counties, said WellStar welcomes questions from patients who are reviewing data or who want more information about how the health system combats infections and other problems. "We have a very open, transparent approach," she said.
Piedmont Hospital posts its internal quality data on its website, www.piedmonthospital.org .
"I'm all for reporting as much as we can," said Dr. Leigh Hamby, chief medical officer for Piedmont Healthcare. "We decided to do that even though the state of Georgia doesn't require us to."
Piedmont generally scores well on quality measures. "Our data are pretty good, and even when they're not we put them out there," Hamby said.
Hamby said Piedmont sometimes get calls from patients trying to decide where to have a procedure who ask in advance about the hospital's performance. "I applaud those patients," he said.
Atlanta's Natalie Fisch said she will do more research the next time anyone in her family faces a significant health care decision.
Last October, Fisch prepared for a knee surgery with few worries. The operation was a relatively simple outpatient procedure and the doctor expected her to be up and walking within a few days.
But the day after the surgery, Fisch started running a fever. "I was in severe pain," she said. She went to the Northside Hospital emergency room that evening.
The ER called in an infectious disease doctor and admitted Fisch to the hospital. Doctors administered high-powered antibiotics while running tests to identify the problem. Fisch spent four days in the hospital and eventually recovered from an infection that apparently had been present on her skin. Fisch said she still doesn't know exactly what went wrong , but she suspects that her skin may not have been properly sanitized before the operation.
The complication proved costly. Fisch was in bed for two weeks and was on crutches for eight weeks. The extra care cost her thousands of dollars, not to mention thousands more spent by her insurance company.
Fisch said she was surprised that she got no follow-up calls from anyone tracking or investigating the infection. The next time she or a family member faces a procedure, she said, she will get multiple opinions about whether the procedure is necessary, while also researching facilities as much as possible.
"I would want to know from that surgery center -- what is your history?" she said.
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