Two very important and largely unanswered questions in U.S. health care are: why is the cost of in-patient medical care so high and so variable from hospital to hospital, and why do so many patients get new infections during their hospitalization? Furthermore, there is no correlation between the cost of medical care and the clinical outcome of the patient. For example, on a national scale, the cost of our medical system is the highest in the world, yet we are only the 20th in good patient outcomes. And tragically, health care-associated infections (HAIs) kill over twice as many people each year as do automobile accidents in the United States.
Could these two areas of confusion be related? In other words, does the cost of treating additional, albeit unintended, patient illness resulting from the hospitalization contribute to high and variable medical expenses? To date, this question is unanswered because the underlying data for each component is extremely difficult to obtain. The statistics on errors in patient care, such as HAIs, are often buried in diagnostic codes that are impossible to decipher. Tallying the costs of a hip replacement in one hospital compared to another is the subject of large, government-funded grants. Until we can collect understandable and accurate data on the numbers of patients harmed, the cost of treating the consequent illness, and the characteristics of the indoor hospital environment where HAIs occur, our understanding will remain incomplete.