title: The "zero risk" concept for hospital-acquired infections: a risky business!
abstract: Nosocomial infections represent a serious public health problem. Some recent studies, most of which used strong educational programs, showed a dramatic decrease in the rates of nosocomial infections, particularly catheter-related infections in the intensive care unit. Thus, the concept of "zero risk" is flourishing in the recent literature, and some insurance networks have decided to limit reimbursement for treatment of some of the health care-associated infections, on the grounds that most of them are preventable. This viewpoint article emphasizes the risk of such a position and enumerates the reasons why such a philosophy could be counterproductive. In particular, this philosophy does not fit with the concept of self-declaration of severe adverse events and could push clinicians to underreport those events.
authors.affiliation: Haute Autorité de Santé, Saint-Denis La Plaine, and 2Université Claude Bernard, Lyon, France. j.carlet@has-sante.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Carlet
authors.forename: Jacques
authors.initials: J
authors.lastname: Fabry
authors.forename: René
authors.initials: R
authors.lastname: Amalberti
authors.forename: Laurent
authors.initials: L
authors.lastname: Degos
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D019985:Benchmarking; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D017048:Health Care Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement; D011787:Quality of Health Care; D018570:Risk Assessment; D018805:Sepsis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States