U.S. Hospital Medical Errors Kill 195,000 Annually

From: tcomeau (tunderbar_at_hotmail.com)
Date: 07/28/04

Date: 28 Jul 2004 12:02:40 -0700

U.S. Hospital Medical Errors Kill 195,000 Annually: Report
By Amanda Gardner
HealthDay Reporter

TUESDAY, July 27 (HealthDayNews) -- An estimated 195,000 people in the
United States die each year due to potentially preventable medical
errors in hospitals, a new report contends.

That's almost twice the number reported by the Institute of Medicine
(IOM) in its landmark 1999 report, To Err Is Human, which cited 98,000
preventable deaths each year.

According to HealthGrades Inc., a health-quality ratings company that
produced the latest report, the death toll is equivalent to three
fully loaded jumbo jets crashing every other day for the last five
years. That would make hospital medical errors the sixth-leading cause
of death in the United States, after diabetes, influenza, pneumonia,
Alzheimer's disease and kidney disease.

IOM representatives acknowledge that the actual number of medical
errors occurring in the nation's hospitals may be more than was
reported in 1999.

"We have always stated that the estimates published in To Err Is Human
are probably conservative estimates," said Christine Stencel, an IOM

But one author of the IOM study points to several methodological
problems with the new report that could have inflated the findings.

The HealthGrades report used 16 of 20 "Patient Safety Indicators"
developed by the federal Agency for Healthcare Research and Quality to
screen hospital administrative data for safety-related incidents from
2000 through 2002.

In all, the report looked at 37 million Medicare patient records,
representing about 45 percent of all hospital admissions in the United
States -- not including obstetrics patients.

Medicare is the federal health insurance program for people 65 or
older, some disabled people under 65 years of age, and those with
end-stage renal disease -- permanent kidney failure.

There were about 1.14 million "safety-related incidents" associated
with 323,993 deaths in hospitals during the period reviewed by
HealthGrades, which is based in Denver. Eighty-one percent of those
deaths were directly attributable to the incident.

And one in every four Medicare patients who experienced an incident
died, the report found.

"Failure to rescue" (which refers to failure to diagnose and treat
conditions that develop in a hospital), bedsores, and postoperative
sepsis accounted for almost 60 percent of all " safety-related
incidents," according to the report.

The report's authors said these errors accounted for $8.54 billion in
excess costs to the Medicare system over the three years studied. If
that number were extrapolated to the entire United States, it would
mean an extra $19 billion was spent and more than 575,000 preventable
deaths occurred from 2000 to 2002, the authors concluded.

That information, however, should not be extrapolated, other health
experts said.

"Medicare patients have a higher adverse event rate because they have
a lot more treatments, they're sicker, they have multiple diseases, so
the mortality rate, the error rate, all these things are higher," said
Dr. Lucian Leape, adjunct professor of health policy at the Harvard
School of Public Health, and one of the authors of the IOM report.

Furthermore, he added, "failure to rescue" is not normally used in
calculating deaths from medical errors; it's not an accepted standard.

Regardless of the actual number of medical errors in this country,
authors of both the current and previous study agree something needs
to be done.

"The magnitude of this is significant. We need to address this and we
need to have support from the medical community," said Dr. Samantha
Collier, lead author of the new report and vice president of medical
affairs at HealthGrades.

"I think it's a safe bet to say that we've maybe gotten a little
complacent about patient safety in the medical community, and this is
just re-sparking and refueling debate around how to address this.
Hopefully, it is creating a sense of urgency, " she said.

Leape added, "Most of us would like to see the attention off counting
numbers and [on to] why aren't we doing more to improve safety, which
is really the issue."