It has been over half a decade since the Institute of Medicine (IOM) released its first reports on health care quality and medical errors. In that report they noted that, “serious and widespread problems occur in small and large communities alike, in all parts of the country.”
A 1997 study in the Journal of the Medical Association (JAMA) showed that Adverse Drug Events (ADEs) were responsible for as many as “140,000 deaths annually in the United States.” A 2000 statement in the Morbidity and Mortality Weekly Report (MMWR) showed that secondary infections acquired in hospitals accounted for “88,000 deaths” each year and that secondary infection problems also occur in “nursing homes, outpatient clinics, dialysis centers, and other sites of healthcare delivery.”
According to the U.S. Department of Health and Human Services the Medicare Program is the second-largest social insurance program in the U.S., with 42 million beneficiaries and total expenditures of $309 billion in 2004. An April 2006 report by HealthGrades (http://www.healthgrades.com/) examines the current state of medical errors.
The report starts, “there are several estimates on the number of medical errors and associated deaths. Most of these estimates would rank medical errors as a leading cause of death in the U.S. However, these well-accepted figures likely represent only the tip of the medical-error iceberg.”
The report states that from 2002 to 2004 there were approximately 1.24 million patient safety incidents in almost 40 million hospitalizations under the Medicare program. These incidents were associated with an excess cost of an estimated $9.3 billion. Worse still the number of incidents have increased for the second year in a row “up from 1.14 and 1.18 million reported in HealthGrades’ First and Second Annual Patient Safety in American Hospitals studies, respectively.”
“Of the 304,702 deaths that occurred among patients who developed one or more patient safety incidents, 250,246 were potentially preventable.” This amounts to about 83,000 deaths each year. “Medicare beneficiaries that developed one or more patient safety incidents had a one-in-four chance of dying during the hospitalization during 2002-2004.”
Each state was ranked in the HealthGrades study, “Minnesota, Wisconsin, Iowa, Michigan and Kansas ranked as the top states for hospital patient safety and New Jersey, New York, Nevada, Tennessee and District of Columbia ranked last.”
“If all the hospitals performed at the level of Distinguished Hospitals for Patient Safety, approximately 280,134 patient safety incidents and 44,153 Medicare deaths could have been avoided while saving U.S. $2.45 billion during 2002-2004.”
What is more distressing is that this report only examines Medicare patients. These 42 million do not include another 43 million patients that are provided for under the Medicaid program. 6 million patients are eligible under both programs. Also, these 42 million patients only represent 1/7th of the entire United States population of 294 million.
Assuming equal problems under the Medicaid program then the combined 80 million under both programs would result in 155,190 potentially preventable deaths each year. If these errors are only half as great throughout the rest of the United States population a possible additional 200,000 deaths are occurring each year in the rest of the patient population. These combined numbers would account for 350,000 potentially preventable deaths each year in the United States.
Using HealthGrades’ numbers each day and estimated 228 people die from preventable medical errors. Using the upper number of 350,000 could mean the number could be as many as 950 preventable deaths occur each day.
SOURCE: HealthGrades Third Annual Patient Safety in American Hospitals Study April 2006
Source: HealthGrades Third Annual Patient Safety in American Hospitals Study April 2006