HealthGrades patient safety study shows increase in hospital
incidents, gaps among state, hospitals…Incidents cost Medicare $9.3
billion over 3 years; patients at top-performing hospitals have 43
percent lower incidence of medical errors compared to worst;
Minnesota, ranked #1, is success story
Patient safety incidents in American hospitals grew from 1.18
million to 1.24 million among the 40 million hospitalizations
covered under the Medicare program, and incidents varied widely from
state to state, and among the best and worst hospitals, according to
a
study
released today by HealthGrades, the leading healthcare
ratings company.
"Overall we see the number of patient safety incidents in
American hospitals continuing to increase, at an enormous cost, and
we still see a large gap between the incidence rates at the nation's
top-performing and worst-performing hospitals," said Dr. Samantha
Collier, HealthGrades vice president of medical affairs. "But we do
find the results of serious attempts to grapple with this issue in
the success of top-performing hospitals and in progressive states
like Minnesota."
The third HealthGrades Patient Safety in American Hospitals
study, the largest annual study of its kind, also finds:
Differences Among Hospitals
Medicare patients going to hospitals ranked among the top 15
percent in terms of patient safety incidents had, on average, 43
percent lower incidence of patient safety incidents compared to
bottom-ranked hospitals
If all hospitals performed at the level of the top 15
percent, 280,134 fewer patient safety incidents and 44,153 fewer
deaths among Medicare patients would have occurred, saving $2.45
billion during the years 2002 through 2004
Of the 304,702 deaths that occurred among patients who
developed one or more patient safety incidents, 250,246 were
potentially preventable
Medicare beneficiaries experiencing one or more patient
safety incidents had a one-in-four chance of dying during their
hospitalization, a rate that is unchanged since HealthGrades' first
study
Number and Cost of Patient Safety Incidents
Approximately 1.24 million total patient safety incidents
occurred among the nearly 40 million hospitals under the Medicare
program over the years 2002, 2003 and 2004. That compares with 1.18
million over the previous three-year period, and 1.14 million over
the years 2000, 2001 and 2002
These patient safety incidents were associated with $9.3
billion in excess costs during the years 2002 to 2004
State Rankings and Differences
Wide and highly significant gaps in patient safety incidence
levels were discovered between the top-performing states and those
at the bottom over the years 2002, 2003 and 2004
Minnesota, Wisconsin, Iowa, Michigan and Kansas ranked as the
top states for hospital patient safety
New Jersey, New York, Nevada, Tennessee and the District of
Columbia ranked last
Medicare patients in the best state, Minnesota, had an almost
30 percent overall lower relative risk of developing one or more of
the patient safety incidents, compared with the worst state, New
Jersey
Trends in Patient Safety Incidents
The patient safety incidents with the highest prevalence
continue to be failure to rescue, decubitus ulcer and post-operative
sepsis
Failure to rescue improved over the study period, while
post-operative sepsis worsened by almost 25 percent
State Rankings The study ranked the nation's states in terms
of the prevalence of patient safety incidents in each states'
hospitals and are grouped as performing better, as expected, or
worse than expected to a statistically significant degree:
Performed Better Than Expected
1. Minnesota
2. Wisconsin
3. Iowa
4. Michigan
5. Kansas
6. Indiana
7. Ohio
8. Pennsylvania
9. South Dakota
10. North Dakota
11. Montana
12. Utah
13. Florida
14. Washington
15. Connecticut
16. Arizona
Performed As Expected
17. West Virginia
18. Idaho
19. Georgia
20. Maine
21. Illinois
22. Massachusetts
23. Colorado
24. Oklahoma
25. Wyoming
26. Oregon
27. Rhode Island
28. Louisiana
29. North Carolina
30. Missouri
31. Alabama
32. South Carolina
33. Delaware
34. Mississippi
35. Vermont
36. Alaska
37. New Hampshire
38. Texas
39. Virginia
40. Kentucky
41. Nebraska
Performed Worse Than Expected
42. California
43. Hawaii
44. Arkansas
45. Maryland
46. New Mexico
47. District of Columbia
48. Tennessee
49. Nevada
50. New York
51. New Jersey
Minnesota ranked first overall in this year's state ranking by HealthGrades, and
in this state are progressive efforts to improve patient safety.
While twenty-five states now have some form of mandatory reporting
of medical errors, Minnesota was the first state, in 2003, to
legislate mandatory public reporting, using guidelines from the
National Quality Forum. Minnesota's Safest in America program allows
competitive hospitals to work together to share data, highlight best
practices and implement evidence-based, community-tested solutions.
Of the eight non-children's hospital systems participating in the
Safest in America collaborative, four have hospitals that ranked in
the top 15 percent in the national according to this study.
"Two of the patient-safety incidents found in the study to be
among the most prevalent are failure to rescue and post-operative
sepsis," continued Dr. Collier. "Failure to rescue is the inability
to save a hospitalized patient's life when that patient has acquired
in the hospital a complication, such as when a patient admitted for
a total knee replacement develops pneumonia and dies. An example of
post-operative sepsis is when an otherwise previously healthy
patient is admitted for a total knee replacement and develops an
overwhelming bacterial bloodstream infection requiring potent
antibiotics and other treatment resulting in a longer hospital stay
and possibly death. Both of these are areas of focus for the most
progressive hospitals, who have developed successful ways of
minimizing or eliminating deaths from these incidents."
###
Distinguished Hospital Awards and Findings
Based on the study, HealthGrades identified 238 hospitals reaching
the top 15 percent in the nation in terms of patient safety,
qualifying them to receive the HealthGrades Distinguished Hospital
Award for 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' patient
safety records before undergoing a procedure. As a category,
Medicare patients at Distinguished Hospitals experienced patient
safety incidents, on average, 43.27 percent less often than patients
at the bottom 15 percent of all hospitals.