Medical errors are sixth leading cause of death
http://www.healthgrades.com/media/english/pdf/HG_Patient_Safety_Study_Final.pdf
A summary of our findings follows:
1. Approximately 1.14 million total patient safety incidents occurred among the 37 million hospitalizations in the Medicare population from 2000 through 2002.
2. The PSIs with the highest incident rates per 1,000 hospitalizations at risk were Failure to Rescue, Decubitus Ulcer, and Post-operative Sepsis. These three patient safety incidents accounted for almost 60% of all patient safety incidents among Medicare patients hospitalized from 2000 through 2002.
3. Of the total of 323,993 deaths among patient s who experienced one or more PSIs from 2000 through 2002, 263,864, or 81%, of these deaths were potentially attributable to the patient safety incident(s).
4. Failure to Rescue (i.e., failure to diagnose and treat in time) and Death in Low Mortality Diagnostic Related Groups (i.e., unexpected death in a low risk hospitalization) accounted for almost 75% of all mortality attributable to patient safety incidents.
5. Of the remaining 65,972 deaths attributable to the other 14 patient safety indicators (excluding Failure to Rescue and Death in Low Mortality DRGs), almost 75% were in patients with decubitus Ulcer (34,320), Post-operative Pulmonary Embolism or Deep Vein Thrombosis (8,445) or Post-operative Respiratory Failure (6,320).
6. There were small variations in PSI incident rates across hospitals and regions.
7. Overall, the Central and Western regions of the U.S. performed better than the Northeast and Sunbelt.
8. Teaching hospitals and larger hospitals (>200 beds) had slightly higher patient safety incident rates per 1,000 as compared to non-teaching hospitals across most PSIs.
9. Patient safety incidents were more prevalent among medical admissions compared to surgical admissions.
10. Overall, the best performing hospitals (hospitals that had the lowest overall PSI incident rates of all hospitals studied, defined as the top 7.5% of all hospitals studied) had five fewer deaths per 1,000 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.
11. The 16 PSIs studied accounted for $8.54 billion in excess inpatient cost to the Medicare system over 3 years, or roughly $2.85 billion annually. Decubitus Ulcer ($2.57 billion), Post-operative Pulmonary Embolism or Deep Vein Thrombosis ($1.40 billion), and Selected Infections due to Medical Care ($1.71 billion) were the most costly and accounted for 66% of all excess attributable costs from 2000 through 2002.
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Taken in context, this HealthGrades analysis and report seems very reliable. Problem is, too many will make and report assumptions about the findings, and use misleading statements like the one I put in the subject line.
The biggest concern has to do with the reports analysis of "failure to rescue" - the biggest contributer to mortality. Numbers attributed in this category will have to be based on ambiguity. For example, any analysis of circumstances associated with an unexpected death will return recommendations for reducing future incidents, or assign preventable potentially contributing factors. That does not necessarily mean the death was preventable, or a direct result of omission of action. Plus, reporting in this regard is not standardized, and probably not easily converted to a statistical analysis. Still, for the purposes of the Healthgrades report, these numbers are important.
The CDC will not rate medical errors as the 6th leading cause of death. (The subject statement above was my own making based on the CDC list.) Remember folks, the intent of the study was to identify ways to promote better, safer care, it cannot be used to blame the medical establishment for epic amounts of untoward irresponsible death in our society. Our medical establishment should be commended for devising ways to analyze and report causes of death, and to state and address responsibility for things that could have turned out differently. We should count ourselves privileged that hospitals are not widely regarded as places where people go to die - as they were, and are, in much of the world. We should be glad that a scientific method of reporting and accountability even exists.
I've been to hospitals, doctors and clinics several times in my life and haven't been killed once. In fact, I'd probably be dead had I not gone on some occasions.
A summary of our findings follows:
1. Approximately 1.14 million total patient safety incidents occurred among the 37 million hospitalizations in the Medicare population from 2000 through 2002.
2. The PSIs with the highest incident rates per 1,000 hospitalizations at risk were Failure to Rescue, Decubitus Ulcer, and Post-operative Sepsis. These three patient safety incidents accounted for almost 60% of all patient safety incidents among Medicare patients hospitalized from 2000 through 2002.
3. Of the total of 323,993 deaths among patient s who experienced one or more PSIs from 2000 through 2002, 263,864, or 81%, of these deaths were potentially attributable to the patient safety incident(s).
4. Failure to Rescue (i.e., failure to diagnose and treat in time) and Death in Low Mortality Diagnostic Related Groups (i.e., unexpected death in a low risk hospitalization) accounted for almost 75% of all mortality attributable to patient safety incidents.
5. Of the remaining 65,972 deaths attributable to the other 14 patient safety indicators (excluding Failure to Rescue and Death in Low Mortality DRGs), almost 75% were in patients with decubitus Ulcer (34,320), Post-operative Pulmonary Embolism or Deep Vein Thrombosis (8,445) or Post-operative Respiratory Failure (6,320).
6. There were small variations in PSI incident rates across hospitals and regions.
7. Overall, the Central and Western regions of the U.S. performed better than the Northeast and Sunbelt.
8. Teaching hospitals and larger hospitals (>200 beds) had slightly higher patient safety incident rates per 1,000 as compared to non-teaching hospitals across most PSIs.
9. Patient safety incidents were more prevalent among medical admissions compared to surgical admissions.
10. Overall, the best performing hospitals (hospitals that had the lowest overall PSI incident rates of all hospitals studied, defined as the top 7.5% of all hospitals studied) had five fewer deaths per 1,000 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.
11. The 16 PSIs studied accounted for $8.54 billion in excess inpatient cost to the Medicare system over 3 years, or roughly $2.85 billion annually. Decubitus Ulcer ($2.57 billion), Post-operative Pulmonary Embolism or Deep Vein Thrombosis ($1.40 billion), and Selected Infections due to Medical Care ($1.71 billion) were the most costly and accounted for 66% of all excess attributable costs from 2000 through 2002.
-----------------------------------------------------------------------------------
Taken in context, this HealthGrades analysis and report seems very reliable. Problem is, too many will make and report assumptions about the findings, and use misleading statements like the one I put in the subject line.
The biggest concern has to do with the reports analysis of "failure to rescue" - the biggest contributer to mortality. Numbers attributed in this category will have to be based on ambiguity. For example, any analysis of circumstances associated with an unexpected death will return recommendations for reducing future incidents, or assign preventable potentially contributing factors. That does not necessarily mean the death was preventable, or a direct result of omission of action. Plus, reporting in this regard is not standardized, and probably not easily converted to a statistical analysis. Still, for the purposes of the Healthgrades report, these numbers are important.
The CDC will not rate medical errors as the 6th leading cause of death. (The subject statement above was my own making based on the CDC list.) Remember folks, the intent of the study was to identify ways to promote better, safer care, it cannot be used to blame the medical establishment for epic amounts of untoward irresponsible death in our society. Our medical establishment should be commended for devising ways to analyze and report causes of death, and to state and address responsibility for things that could have turned out differently. We should count ourselves privileged that hospitals are not widely regarded as places where people go to die - as they were, and are, in much of the world. We should be glad that a scientific method of reporting and accountability even exists.
I've been to hospitals, doctors and clinics several times in my life and haven't been killed once. In fact, I'd probably be dead had I not gone on some occasions.
posted by nawledge at
7:21 PM
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