Hospital errors kill nearly 200,000 every year

[Darth Wong]

New study indicates that the death toll from hospital errors is even larger than previously suspected:

http://www.cnn.com/2004/HEALTH/07/28/he ... index.html

Study: Hospital errors cause 195,000 deaths

WASHINGTON (Reuters) -- As many as 195,000 people a year could be dying in U.S. hospitals because of easily prevented errors, a company said Tuesday in an estimate that doubles previous figures.

Lakewood, Colorado-based HealthGrades Inc. said its data covers all 50 states and is more up-to-date than a 1999 study from the Institute of Medicine that said 98,000 people a year die from medical errors.

"The HealthGrades study shows that the IOM report may have underestimated the number of deaths due to medical errors, and, moreover, that there is little evidence that patient safety has improved in the last five years," said Dr. Samantha Collier, vice president of medical affairs at the company.

The company, which rates hospitals based on a variety of criteria and provides information to insurers and health plans, said its researchers looked at three years of Medicare data in all 50 states and Washington, D.C.

"This Medicare population represented approximately 45 percent of all hospital admissions (excluding obstetric patients) in the U.S. from 2000 to 2002," the company said in a statement.

HealthGrades included as mistakes failure to rescue dying patients and the death of low-risk patients from infections -- neither of which the Institute of Medicine report included.

It said it found about 1.14 million "patient-safety incidents" occurred among the 37 million hospitalizations.

"Of the total 323,993 deaths among Medicare patients in those years who developed one or more patient-safety incidents, 263,864, or 81 percent, of these deaths were directly attributable to the incidents," it added.

"One in every four Medicare patients who were hospitalized from 2000 to 2002 and experienced a patient-safety incident died."

The U.S. government said it is trying to spearhead a move to get hospitals and clinics to use electronic databases and prescribing methods. The Institute of Medicine report said many deaths were due to medication prescribing errors or to errors in delivering medications.

"If the Centers for Disease Control and Prevention's annual list of leading causes of death included medical errors, it would show up as number six, ahead of diabetes, pneumonia, Alzheimer's disease and renal disease," Collier said.

The release of this study just happens to dovetail nicely into comments in a previous thread about how the medical industry is not harsh enough on mistakes.

[Stormbringer]

Hmm, it's intersting that they used strictly Medicare patients. I can't help but wonder if that's skewed the results some.

HealthGrades included as mistakes failure to rescue dying patients and the death of low-risk patients from infections -- neither of which the Institute of Medicine report included.

I'd be interested to know why they included those. Because it's hard to say whether those are genuine errors or not. I mean failure to rescue dying patients could theoretically cover a lot of people that died and would have under the best circumstances.

[Darth Wong]

Hmm, it's intersting that they used strictly Medicare patients. I can't help but wonder if that's skewed the results some.

Because they're easily tracked and represent nearly half of all hospital admissions. This is a far, far larger sample than what is normally done in social studies of any kind.

HealthGrades included as mistakes failure to rescue dying patients and the death of low-risk patients from infections -- neither of which the Institute of Medicine report included.

I'd be interested to know why they included those. Because it's hard to say whether those are genuine errors or not.

Why?

I mean failure to rescue dying patients could theoretically cover a lot of people that died and would have under the best circumstances.

Would have eventually died, perhaps, depending on the scenario. But it indicates that a life-saving action which should have been taken was not taken.

[Stormbringer]

Because they're easily tracked and represent nearly half of all hospital admissions. This is a far, far larger sample than what is normally done in social studies of any kind.

Yes, it is a large survey. But it's also Medicare which has a reputation for going for cheap care and so generalizing that to the health system overall might not be totally accurate.

Why?

Why what? The next sentence explains exactly what I mean.

Would have eventually died, perhaps, depending on the scenario. But it indicates that a life-saving action which should have been taken was not taken.

And you know this how? Because all I see is failure to save dying patients which details nothing at all of why they failed or what the criteria was for it to be counted.

[Darth Wong]

Yes, it is a large survey. But it's also Medicare which has a reputation for going for cheap care and so generalizing that to the health system overall might not be totally accurate.

And private HMOs don't go for the cheapest care? They have no particular concern for profit? Please tell me you're joking.

And you know this how? Because all I see is failure to save dying patients which details nothing at all of why they failed or what the criteria was for it to be counted.

So in essence, with no real evidence that this is the case, you have concluded that the study is just making up incidents out of thin air.

[Stormbringer]

And private HMOs don't go for the cheapest care? They have no particular concern for profit? Please tell me you're joking.

I didn't say they weren't concerned with profit but they are generally as a step or more above Medicare.

So in essence, with no real evidence that this is the case, you have concluded that the study is just making up incidents out of thin air.

No, I'm saying before I conclude that the medical industry is run by negligent monsters (as you seem to have long ago) I'd like to see the criteria that they applied and why those were included where as they were not in another study. One which also happened to get drastically different results.

[Darth Wong]

I didn't say they weren't concerned with profit but they are generally as a step or more above Medicare.

And where did you get this idea from?

So in essence, with no real evidence that this is the case, you have concluded that the study is just making up incidents out of thin air.

No, I'm saying before I conclude that the medical industry is run by negligent monsters (as you seem to have long ago) I'd like to see the criteria that they applied and why those were included where as they were not in another study.

Because the previous study ignored that entire category. Read the article.

One which also happened to get drastically different results.

No, it didn't. It ignored an entire category of errors, hence the discrepancy. This study found that the rate of errors itself had not changed; it was just more comprehensive in examining the consequences of those errors.

[Stormbringer]

I didn't say they weren't concerned with profit but they are generally as a step or more above Medicare.

And where did you get this idea from?

Jee, I wonder. Maybe the not so uncommon bitching about the problems of Medicare?

So in essence, with no real evidence that this is the case, you have concluded that the study is just making up incidents out of thin air.

No, I'm saying before I conclude that the medical industry is run by negligent monsters (as you seem to have long ago) I'd like to see the criteria that they applied and why those were included where as they were not in another study.

Because the previous study ignored that entire category. Read the article.

One which also happened to get drastically different results.

No, it didn't. It ignored an entire category of errors, hence the discrepancy. This study found that the rate of errors itself had not changed; it was just more comprehensive in examining the consequences of those errors.

First of all, let me say well fucking duh.

Second, that doesn't at all answer how and why they included them.

[Darth Wong]

And where did you get this idea from?

Jee, I wonder. Maybe the not so uncommon bitching about the problems of Medicare?

Translation: subjective perception.

First of all, let me say well fucking duh.

Second, that doesn't at all answer how and why they included them.

Are you suggesting that errors of omission when dealing with terminal patients or deaths to low-risk patients from infection SHOULD be categorically ignored?

[PicardShark]

Hmm, since my mom is a nurse, I know how difficult caring for people can be. But, still, you expect proper treatment from a hospital, and if the numbers are true, it's not a very comforting trend.

[Graeme Dice]

Are you suggesting that errors of omission when dealing with terminal patients or deaths to low-risk patients from infection SHOULD be categorically ignored?

Well, the study itself is located at:
http://www.healthgrades.com/media/engli ... _Final.pdf

It's pretty vague as to what failure to rescue actually means.

[Darth Wong]

Are you suggesting that errors of omission when dealing with terminal patients or deaths to low-risk patients from infection SHOULD be categorically ignored?

Well, the study itself is located at:
http://www.healthgrades.com/media/engli ... _Final.pdf

It's pretty vague as to what failure to rescue actually means.

It says failure to rescue means "failure to diagnose and treat in time."

More to the point, it describes a medical error as: "the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim…[including] problems in practice, products, procedures, and systems", and each incident involved a medical error of some sort.

In fact, the more you look at the specific data in the study, the more frightening it is: look at the last page! More than 35,000 "accidental puncture" incidents alone every year, for fuck's sake!

Hell, you could categorically remove the entire "failure to rescue" figures (as if 100% of them are found to be non-errors for some inexplicable reason which no one has yet presented apart from appeals to ignorance) and still have in excess of 130,000 deaths.

[MKSheppard]

Holy shit, Doctors are fucking lethal weapons!

[BlkbrryTheGreat]

Wow.... .5% death rate using the WORST (and likely biased) figure provided. Color me unimpressed.

[Darth Wong]

Wow.... .5% death rate using the WORST (and likely biased) figure provided. Color me unimpressed.

Yeah, it's only around the same order of magnitude as the death rate from GOING TO FUCKING IRAQ. And mind you, that's not the total death rate; it's the death rate strictly from REPORTED errors, ie- they use administrative data. The phenomenon of underreported or covered-up mistakes is completely ignored.

Or, to put this in terms which might mean something to you, there rate of people being "accidentally punctured" by their own doctors in the US is three times higher than the FIREARMS MURDER RATE.

[Arthur_Tuxedo]

Thank god I have a physician I can trust, because I don't trust the medical system in general farther than I can throw it, and it's pretty fucking heavy.

[Howedar]

I can't say I'm surprised by these numbers, but I wish I could be.

[Joe]

Well, what can be do about this?

[Joe]

That should be "what can be done about this?"

[Darth Wong]

In general, you make more mistakes when you're rushing. It probably has something to do with overwork, but there's also a cultural issue. Unless I'm misinformed about this, the medical ethics code doesn't seem to have the whistle-blower requirements found in some other codes.

[Boyish-Tigerlilly]

They really do overwork their doctors, especially the younger docotors. Many of them, as well as the older ones, are always on call. I knew a doctor who got only about 4 hours sleep in two days. I don't know how that is legal. It seems like they really don't care about fuck-ups.

[Alyrium Denryle]

Think of it this way... Is there always a way to stop an infection? No. To conclude that deaths from infections are caused by errors is most definently premature. No matter hw well you clean an instrument, there wll always be something left, especially at the rate bacteria mutate to resist antibiotics. Infections really are not all that preventable..

And yes, doctors, especially residents are extremely overworked. Often pulling 24 or even 36 hour shifts in the trauma ward. Sleep deprivation is bad children.

[Darth Wong]

Think of it this way... Is there always a way to stop an infection? No. To conclude that deaths from infections are caused by errors is most definently premature. No matter hw well you clean an instrument, there wll always be something left, especially at the rate bacteria mutate to resist antibiotics. Infections really are not all that preventable..

Read the fucking study, Alyrium. They do NOT automatically assume that any death from infection was caused by an error. They have specific criteria for a medical error, based on hospital administrative records. They had to either fail to carry out a planned action properly or plan the wrong action, based on review.

And yes, doctors, especially residents are extremely overworked. Often pulling 24 or even 36 hour shifts in the trauma ward. Sleep deprivation is bad children.

This is interesting because trucking companies are forced to limit the number of hours drivers can work in a row, while hospitals do no such thing.

[Uraniun235]

Thank god I have a physician I can trust, because I don't trust the medical system in general farther than I can throw it, and it's pretty fucking heavy.

I have to agree. I really like going to an office just a few miles down the road to a physician that knows who I am and can take the time to really talk to me about any problems I have, as well as explain what he thinks is the problem and what he can do to solve it.

Or, to put this in terms which might mean something to you, there rate of people being "accidentally punctured" by their own doctors in the US is three times higher than the FIREARMS MURDER RATE.

I wonder what an "accidental puncture" is, because I've had some nurses who had to stick me several times before they could finally get blood out of me.

[Alyrium Denryle]

I stand corrected.

Though the overwork is interesting, and I have always wondered what the rational behind it is.