Posted by & filed under Infectious Diseases and Infection Control.

 

A recent study in the Journal of Patient Safety estimates that as many as 210,000 to 440,000 patients who go to the hospital for healing die each year as a result of preventable medical deaths. This makes medical errors the third-leading cause of death in the United States, behind heart disease and cancer.

In 1999, the Institute of Medicine published the famous report “To Err is Human” which created an enormous uproar when it reported that up to 98,000 people die every year because of mistakes made in hospitals. The number, equivalent to a jumbo jet with over 268 passengers crashing every day, was widely disputed when it was first published. It is now accepted by physicians and hospital officials.

According to James (2013), the study’s author, the United States, at the national level, is distinguished by a hodgepodge of medical care subsystems that require patients to navigate a complex maze of providers in an effort to seek effective and affordable care. Providers are required to be more and more productive in suboptimal working conditions, cope with decreased numbers of health care staff, and a national shortage of physicians, leading to fatigue and burnout.  The United States lags behind other developed nations in the implementation of electronic medical records and the information a health care provider needs to optimize patient care is not readily available. Preventable adverse affects (PAEs) are believed to be the result of all of these factors.

This study was a literature review that identified four studies of more than 4,200 patients between 2002 and 2008 using the Global Trigger Tool to highlight specific evidence in medical records that pointed to adverse events that may have harmed a patient. Medication stop orders, prescriptions for antidote medications, abnormal laboratory results, and infections were examples of triggers noted by the Tool.  By combining findings and then extrapolating them across 34 million hospitalizations in 2007, James concluded that preventable errors contribute to a minimum of 210,000 hospital deaths annually. The study notes that because of the limitations of the search capability of the tool and the incompleteness of most medical records, the true number of premature deaths associated with PAEs is probably than 400,000 per year. The level of serious harm to patients is estimated to be 10-20 times more commonthan actual patient deaths (James, 2013).

According to Allen (2013), the American Hospital Association has not attempted to come up with its own estimate of annual patient deaths and remains more comfortable with the IOM’s 1999 estimate.  Interestingly, in 2010, the Office of the Inspector General for Health and Human services said that poor hospital care contributed to the deaths of 180,000 hospitalized Medicare patients (approximately 13.5%) alone in any given year, almost double the IOM’s estimate of 1999 (Levinson, 2010).

While many individuals continue to argue about how many patients deaths are accelerated because of poor hospital care, others agree that the real issue is too many people are being harmed by unintentional medical errors.  Assertive action on the part of providers, legislators, and individuals is needed to support long-overdue changes and increased vigilance in health care to address the problem of harm to patients who come to a hospital for care (James, 2013).

REFERENCES

Allen, M. (2013). How many die from medical mistakes in U. S. hospitals? Retrieved October 10, 2013 from http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals

James, John T. (2013). A new, evidence-based estimate of patient harms associated with hospital care.Journal of Patient Safety, 9(3), 122-128.

Levinson, D. R. (2010). Adverse events in hospitals: National incidence among Medicare beneficiaries. Department of Health and Human Services Office of Inspector General. OEI-06-09-00090.  Retrieved October 10, 2013 from http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf