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.