Hospital Errors Rising - 247,662 Deaths Over Three Years???

It is getting worse.

Healthgrades reports that the number of errors in our nation's hospitals rose 3% over the years 2002 - 2005.  From the press release:

The HealthGrades study of 40.56 million Medicare hospitalization records over the years 2003 to 2005 ... found:
• Patient-safety incidents continue to rise in American hospitals, with 1.16 million preventable
patient-safety incidents occurring over the three years studied among Medicare patients in the
nation's hospitals, an incidence rate of 2.86 percent.
• 247,662 deaths were potentially preventable over the three years, and Medicare patients who had one or more patient-safety incidents had a one-in-four chance of dying.
• The excess cost to hospitals was $8.6 billion over three years, with some of the most common
incidents proving to be the most costly.
• Ten of the 16 patient-safety incidents tracked worsened from 2003 to 2005, by an average of
almost 12 percent, while seven incidents improved, on average, by six percent. Patient-safety
incidents with the greatest increase in incident rates were post operative sepsis (34.28 percent),
post-operative respiratory failure (18.70 percent) and selected infections due to medical care
(12.23 percent).
• Patient-safety incidents with the highest incidence rates were decubitus ulcer, failure to rescue
and post-operative respiratory failure.

And check this out:  242 hospitals constitute the top 5% of those studied.  On average, these hospitals had a 40 percent lower rate of patient-safety incidents when compared with the poorest-performing hospitals. If all hospitals performed at the level of the Distinguished Hospitals for Patient Safety, the study found (a) approximately 206,286 patient-safety incidents and 34,393 Medicare deaths could have been avoided; and (b) $1.74 billion could have been saved.

These are the safety incidents studied:

• Accidental puncture or laceration
• Complications of anesthesia
• Death in low-mortality DRGs
• Decubitus ulcer
• Failure to rescue
• Foreign body left in during procedure
• Iatrogenic pneumothorax
• Selected infections due to medical care
• Post-operative hemorrhage or hematoma
• Post-operative hip fracture
• Post-operative physiologic metabolic
derangement
• Post-operative pulmonary embolism or
deep vein thrombosis
• Post-operative respiratory failure
• Post-operative sepsis
• Post-operative abdominal wound
dehiscence
• Transfusion reaction

Read the study here.

What about Tennessee hospitals?  They "performed worse than expected" and were ranked 48th in the country, beating only Nevada, New York and New Jersey.  See the rankings here.  This source says that "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."

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Chris - April 6, 2007 10:54 PM

It must be noted that HealthGrades makes their reports by accessing hospitals self reported data. Additionally, it includes known complications as "safety incidents" such as post-operative sepsis, post-op respiratory failure. When you take care of sick patients, these things happen. If you look at the "top hospitals", it becomes clear that they are the smaller hospitals who ship all their sick patients out to the medical centers who are the "bad hospitals". Here in Tennessee we have the wonderful benefit of having many medical centers that are caring for patients from southern Kentucky, Northern Georgia and Alabama who are transfered in because they are not able to provide the care for them.

John Day - April 7, 2007 6:40 AM

Good point. I know of a surgeon in Nashville who, unfortunately, gets sued because he represents the surgeon of choice for high-risk, secondary surgical procedures. In other words, he gets other people's errors and tries to fix them. When the patients die he gets thrown in the mix. Although his poor bedside manner contributes to the problem, the fact of the matter is that he is part of the solution, not the problem.

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