Tuesday, August 17, 2010

You didn't really want that data, did you?

Missouri, one of the first states to pass legislation requiring hospitals to reveal annual HAI rates, has possibly  deleted all their infection rate data collected from 2005-2008.  State officials say that the data is too costly to maintain, and mention the sensitivity of the data as another motivating factor. 

However, the law doesn’t explicitly give authority to the state health department to delete the infection data, or the associated tables and results produced from data analysis.  The statute says “The data collected or published shall be available to the department”.  Subsequent requests for the data by the St. Louis Post-Dispatch got conflicting answers; one state official said the data was deleted, another said that the data was available, just “not handy.”

The department later said it would take public requests for information, but they would only be honored if a programmer was available and only if the requester was willing to pay the retrieval costs.  The state data manager, Mark Van Tuinen, cited budgetary constraints as the reason for data deletion, saying “Given our skimpy resources, we’re pretty much doing what the law tells us to do” – keep data compiled for a period of 12 months. 

A note on the state health website says “Due to the sensitive nature of the data and limited resources, DHSS staff cannot provide data or records beyond what are displayed on this website.”  Van Tuinen added, “Hospitals are sensitive about comparisons with each other.”

While it’s impossible to track the changes in infection rates without the data, it is interesting to note that the 2004 law establishing these reporting requirements did not allocate any funds with which to accomplish them. Missouri apparently had to face the question of how to keep the data accessible without any money to do it.  Fortunately for the public, the St. Louis Area Business Health Coalition backed up the data each year before it was removed, so even if Missouri did delete the data, it does still exist.

Regardless of whether the data was actually deleted or not, the issue certainly raises questions about how states should frame and implement the laws that require them to report and store HAI data, and how to best serve the public while doing so.

St. Louis Post-Dispatch story: http://www.stltoday.com/business/article_9959b4e1-2634-5722-b21d-c32876d205a0.html

DHSS website with reporting note: http://www.dhss.mo.gov/HAI/definition.html

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