Missouri was in the vanguard back in 2004 when it passed a law requiring hospitals to publicly report infection rates.

Since then, as other states have embraced even more aggressive reporting requirements, the Show-Me State has fallen behind.

Major gaps in the infection reporting law have gone unfilled. Even those infections that had been reported didn’t remain public for long.

As reporter Jim Doyle explained in Monday’s Post-Dispatch, the state health department has been removing past infection reports as it adds new information to its website.

The site contains about one year’s worth of reports. That makes it impossible to establish trends, which is crucial to tracking hospital performance.

On Tuesday, Missouri Department of Health and Senior Services Director Margaret Donnelly said workers immediately would begin adding past reports to the website so that they can be read by consumers. She did not know how long it would take.

A health department spokesman had told Mr. Doyle that the material is too costly to maintain. That’s a familiar story to long-time residents of what this newspaper once dubbed the “Fortysomething State.”  State government departments have sometimes lacked sufficient funds to perform the duties assigned to them.

But Ms. Donnelly said cost wasn’t the issue here. She said that the decision to keep only one year’s data online was made in 2006, when the first reports were posted.

As many as one in 20 patients acquires an infection at some point during a hospital stay. About three-quarters of those infections are thought to be preventable.

Public reporting is crucial to protecting patients — and not just those who are or will be in hospitals over the next year or so.

Experts say dangerous, drug-resistant bacteria that first develops in hospitals and nursing homes don’t stay there. Instead, they migrate into the community, causing problems for a new population of patients.

The poster child for that kind of unwelcome evolution is methicillin-resistant Staphylococcus aureus, better known as MRSA. It once was found only in hospital intensive care units and nursing homes; now, most cases are diagnosed elsewhere.

Former St. Louis County Executive George “Buzz” Westfall and Rams radio broadcaster Jack Snow both died from staph infections.

Infections are especially dangerous in intensive care units, where the sickest patients are treated.

They also pose risks on other hospital floors, but Missouri law only requires hospitals to report infections in intensive care units. It should be expanded to include all hospital-acquired infections, as well as all adverse events such as surgery on the wrong patient or body part.

The state health department deserves blame for limiting public access to infection reports. But the health department is not the only culprit.

BJC Health Care has negotiated contracts that prevent insurance companies or other outside entities — including employers, who pay for their workers’ health insurance — from sharing information on quality and cost at its hospitals. Two years ago, lawmakers considered a bill to prohibit such contracts. It was defeated, but it deserves serious consideration when legislators reconvene.

Meanwhile, the stakes for hospitals are getting higher. New federal health care reform requires hospitals to report infection rates beginning next year. Starting in 2012, Medicare payments will be determined in part by hospital infection rates. Hospitals with high rates will be paid less; those that do a good job of preventing infections will earn more.

Ultimately, sunlight and scrutiny is the best protection against hospital-acquired infections.