Friday, March 6, 2009

Hospital infections - the saga continues

I am glad that following Salma Khalik's report that there have been a flurry of hospital and MOH responses appearing in today's Straits Times. If nothing else it would appear that they have taken cognizance of the groundswell of public concern.

It would appear that some sort of 'awareness' had arisen at their level back in 2007, and that there were some (albeit kinda half-hearted) attempts then to deal with the problem. That was back then. Hopefully this display of public angst may provoke them to adopt more concrete and enduring solutions.

So far, they seem only to be playing with numbers. Sure, there is a problem with definitions. But to sit back and wring their hands for 2 years knowing the stats are not meaningful because of a non-harmonised approach towards data collection smacks of a fairly large dose of a 'boh chap' attitude. I mean, if you are really interested in the data, it doesn't take too much effort to standardize the definition regardless of the limitations. And why not provide the public with a tracking of this problem over the years? Don't just tell us the comparisons between the worst year and the best. Don't fudge by playing with the denominator to make the numbers look miniscule (per patient days? errmmm...why not per patient seconds?). Is the situation really getting better as every hospital seem to suggest? If really so we shouldn't need to worry and these discussions would be totally unnecessary. But I suspect not, so give us the real news.

The MOH provides weekly stats of the reporting of of all kinds of infectious diseases. Why can't the MOH tell us the yearly-hospital incidences and let us judge for ourselves if the situation is really under control, and which hospital is really biting the bullet where this is concerned?


Anonymous said...

Thank you for continuing to write about this. Your comments are perceptive and the analysis spot-on.

Do continue.

Anonymous said...

Just one correction though. This problem has been there and recognized for at least 10 years in Singapore and the rest of the world.

gigamole said...

Thanks for your encouragements. I do agree with you that the 'awareness' has been there for a long time. My reference to 2007 was mainly because the hospitals all suddenly claimed to have been 'enlightened' in 2007 when they all began on a number of programs to deal with the issue.

We also need to think about the other issue, which is how to do this without over-escalating the health care costs.

Anonymous said...

Most experts seem to believe that reducing hospital infections will reduce health care costs despite the initial heightened expenditure.

Of course, the point of view is important: overall, and for many patients, costs will come down. For the hospitals (and doctors), this may not be the case because they are currently remunerated per procedure/per day of stay, and not because of activities to bring down infection rates. Few hospitals/doctors have made money by helping patients save money!

The danger is that some hospitals will inevitably try to pass some of these costs to the patients.

gigamole said...

It's actually a common problem behind all these 'invisible diseases'.

There is no doubt that one can save health care $$ by dealing preemptively with potential problems such as superinfections etc...the problem is the costs are borne by one cost centre (the operational unit), and savings accrue to a different cost centre over a much longer time frame.

The operational unit therefore looks very wasteful and inefficient while someone else looks good.

Consequently solutions tend to be superficial and target short term gains.

It's a stupid system.

auntielucia said...

Congrats Giga/Gogo on getting your blog mentioned in the Suntimes...

I can't add more to your take on y humans shldn't be vegetarians other than to say it's a question of a)taste and b)how imaginative they r.

Lastly, it's of their funeral what pple choose to eat.

As for MRSA, one way is to tell the cleaners not to use their one mop for everything. Once when i was hospitalised, i woke up fm my anaesthesia to see water drops forming at the aircon outlet on the ceiling. Summoned a nurse and she summoned a cleaner, who promptly used her dirty floor mop to mop the droplets on the ceiling. I survived that. I visited a fren's dying mother a few months later and the same thing took place. My fren's mother died, tho probably not because of the sloppy house-keeping, I hasten to add.

gigamole said...

hehheh....sorry to be frivolous but your story kinda reminded me of another story where the ward doctors couldn't figure out why patients kept dying on 0930 in the morning.

Then someone noticed the cleaner lady coming in with the vacuum cleaner and unplugging the respirators at 0930.