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Medicare Patients Dying at Rate of 195,000 a Year
Due to Medical Errors
One in four Medicare patients hospitalized from
2000 to 2002 and experienced a patient-safety incident died
Aug. 7, 2004 – An average of 195,000
Medicare patients in the U.S. died due to potentially preventable,
in-hospital medical errors in each of the years 2000, 2001 and 2002,
according to a new study of 37 million patient records that was released
in July by HealthGrades, the healthcare quality company.
The HealthGrades Patient Safety in American
Hospitals study is the first to look at the mortality and economic
impact of medical errors and injuries that occurred during Medicare
hospital admissions nationwide from 2000 to 2002.
The HealthGrades study applied the mortality and
economic impact models developed by Dr. Chunliu Zhan and Dr. Marlene R.
Miller in a research study published in the Journal of the American
Medical Association (JAMA) in October of 2003. The Zhan and Miller study
supported the Institute of Medicine’s (IOM) 1999 report conclusion,
which found that medical errors caused up to 98,000 deaths annually and
should be considered a national epidemic.
The HealthGrades study finds nearly double the
number of deaths from medical errors found by the 1999 IOM report “To
Err is Human,” with an associated cost of more than $6 billion per year.
Whereas the IOM study extrapolated national findings based on data from
three states, and the Zhan and Miller study looked at 7.5 million
patient records from 28 states over one year, HealthGrades looked at
three years of Medicare data in all 50 states and D.C. This Medicare
population represented approximately 45 percent of all hospital
admissions (excluding obstetric patients) in the U.S. from 2000 to 2002.
“The HealthGrades study shows that the IOM report
may have underestimated the number of deaths due to medical errors, and,
moreover, that there is little evidence that patient safety has improved
in the last five years,” said Dr. Samantha Collier, HealthGrades’ vice
president of medical affairs. “The equivalent of 390 jumbo jets full of
people are dying each year due to likely preventable, in-hospital
medical errors, making this one of the leading killers in the U.S.”
HealthGrades examined 16 of the 20 patient-safety
indicators defined by the Agency for Healthcare Research and Quality (AHRQ)
– from bedsores to post-operative sepsis – omitting four
obstetrics-related incidents not represented in the Medicare data used
in the study. Of these sixteen, the mortality associated with two,
failure to rescue and death in low risk hospital admissions, accounted
for the majority of deaths that were associated with these patient
safety incidents. These two categories of patients were not evaluated in
the IOM or JAMA analyses, accounting for the variation in the number of
annual deaths attributable to medical errors. However, the magnitude of
the problem is evident in all three studies.
“If we could focus our efforts on just four key
areas – failure to rescue, bed sores, postoperative sepsis, and
postoperative pulmonary embolism – and reduce these incidents by just 20
percent, we could save 39,000 people from dying every year,” said Dr.
Collier.
The HealthGrades study was released in conjunction
with the company’s first annual Distinguished Hospital Award for Patient
SafetyTM, which honors hospitals with the best records of patient
safety. Eighty-eight hospitals in 23 states were given the award for
having the nation’s lowest patient-safety incidence rates. A list of
winners can be found at
http://www.healthgrades.com.
Study Highlights
Among the findings in the HealthGrades Patient Safety in American
Hospitals study are as follows:
> About 1.14 million patient-safety incidents
occurred among the 37 million hospitalizations in the Medicare
population over the years 2000-2002.
> Of the total 323,993 deaths among Medicare
patients in those years who developed one or more patient-safety
incidents, 263,864, or 81 percent, of these deaths were directly
attributable to the incident(s).
> One in every four Medicare patients who were
hospitalized from 2000 to 2002 and experienced a patient-safety incident
died.
> The 16 patient-safety incidents accounted for
$8.54 billion in excess in-patient costs to the Medicare system over the
three years studied. Extrapolated to the entire U.S., an extra $19
billion was spent and more than 575,000 preventable deaths occurred from
2000 to 2002.
> Patient-safety incidents with the highest rates
per 1,000 hospitalizations were failure to rescue, decubitus ulcer and
postoperative sepsis, which accounted for almost 60 percent of all
patient-safety incidents that occurred.
> Overall, the best performing hospitals (hospitals
that had the lowest overall patient safety incident rates of all
hospitals studied, defined as the top 7.5 percent of all hospitals
studied) had five fewer deaths per 1000 hospitalizations compared to the
bottom 10th percentile of hospitals. This significant mortality
difference is attributable to fewer patient-safety incidents at the best
performing hospitals.
> Fewer patient safety incidents in the best
performing hospitals resulted in a lower cost of $740,337 per 1,000
hospitalizations as compared to the bottom 10th percentile of hospitals.
The complete study,
including the list of AHRQ patient-safety indicators, can be found at
http://www.healthgrades.com.
“If the Center for Disease Control’s annual list of
leading causes of death included medical errors, it would show up as
number six, ahead of diabetes, pneumonia, Alzheimer’s disease and renal
disease,” continued Dr. Collier. “Hospitals need to act on this, and
consumers need to arm themselves with enough information to make
quality-oriented health care choices when selecting a hospital.”
Distinguished Hospital Awards and Findings
In addition to its findings on patient safety, HealthGrades today
honored 88 hospitals in 23 states with the Distinguished Hospital Award
for Patient Safety, the first national hospital award to focus purely on
hospital patient safety. The award was designed to highlight hospitals
with the best records of patient safety in the nation and to encourage
consumers to research their local hospitals before undergoing a
procedure.
HealthGrades based the awards on a detailed study
of patient safety events in hospitals nationwide from 2000 to 2002,
using the list of patient-safety incidents developed by AHRQ. “Best”
hospitals were identified as the top 7.5 percent of the hospitals
studied and had significantly different patient-safety incident rates
and costs compared to hospitals that were average or in the bottom 10th
percentile. Among the “best” hospitals, the lower number of avoidable
deaths and in-patient hospital costs were directly related to their
lower overall patient-safety incident rates.
“If all the Medicare patients who were admitted to
the bottom 10th percentile of hospitals from 2000 to 2002 were instead
admitted to the “best” hospitals, approximately 4,000 lives and $580
million would have been saved,” said Dr. Collier.
About HealthGrades
Health Grades, Inc. (OTCBB: HGRD) is the leading independent healthcare
quality company, providing ratings, information and advisory services to
healthcare providers, employers, health plans and insurance companies.
HealthGrades works with healthcare providers to help assess, improve and
promote their quality. HealthGrades provides consumers access to
information about healthcare providers and practitioners through its Web
site and provides liability insurers, employers and payers with critical
information about healthcare quality.
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