Hospital Errors Put More Patients at Risk
April 4, 2007 — -- Nearly 3 percent of patients in the nation's hospitals risk experiencing hospital errors, a new study finds. And the numbers could be on the rise.
The report further suggests that those patients who experience an error in treatment or care at a hospital have a one in four chance of dying from the mistake.
The study, released Tuesday by the independent health care ratings company HealthGrades, followed more than 40 million Medicare hospitalization records from 2003 to 2005.
What it found was that 1.16 million preventable "patient safety incidents" occurred over the three years studied, which means that 2.86 percent of all the patients studied experienced a health problem brought about by their hospital stay.
Worse, because of these incidences, 247,662 patients died from potentially preventable problems.
The cost is measured not only in lives but in dollars as well. The excess cost to hospitals was $8.6 billion over the course of the three-year study, with some of the most common occurrences proving to be the most costly.
The findings add to a growing body of evidence -- most notably, a report by the Institute of Medicine in 2006 -- suggesting that hospitals present many patients with avoidable and sometimes deadly health risks.
"Despite the flurry of research, publications and process improvement activity that has occurred since the [Institute of Medicine] report, there is a growing consensus that not much progress has been made, leading to a visible national impact," the study authors write.
A Growing Problem
The study brings to the forefront a frightening possibility -- that a significant percentage of Americans who are hospitalized every year face health risks from their hospital stay.
The number of Medicare patients suffering from hospital errors "absolutely can be extrapolated" to the U.S. hospital population in general, says Kristin Reed, a spokesperson for HealthGrades and co-author of the study.
"These are patient safety events, so these are events that should not happen, ever."
The complications measured in the study include accidental puncture or laceration, complications of anesthesia, foreign objects left in the patient's body during a procedure and infections spread through medical care.
Dr. David Bates, chief of the general internal medicine division at Brigham and Women's Hospital in Boston, says the findings underscore the fact that patient safety in hospitals is a serious concern.
But are the numbers as bad as they seem? Bates says part of the increase may be due to the fact that the average patient, in general, is in worse health today than those of decades past.
"Patients are getting older and sicker, and they are taking more medications," he says. Sicker patients mean a higher chance of dying while in the hospital, regardless of whether a hospital error was made or not.
But Bates says that even with this in mind, the numbers highlight a severe problem in U.S. hospitals.
"If anything, this is probably an underestimation of the magnitude of the problem," he says, adding that more information will be needed to completely understand the scope of the problem.
"The truth is that there is not really good information when it comes to patient safety," he says.
Hospital Improvements Necessary
Both Reed and Bates say the report reveals certain steps that hospitals must take in order to ensure patient safety.
Bates says, among these steps are adherence to a number of safe practices that have been generally agreed upon within the medical industry to protect patient health. These include such things as more diligent patient evaluation and vaccination of health care workers against disease.
The other is to implement computerized prescribing in order to lessen the impact of medication errors.
"Hospitals, nationally, are financially challenged, and the rate at which they are adopting these practices varies quite a lot," Bates says.
Hence, it appears that some hospitals are better than others when it comes to avoiding potentially deadly errors in treatment. In the HealthGrades study, the nation's top-performing hospitals had a 40 percent lower rate of medical errors when compared with the poorest-performing hospitals.
Can Consumers Protect Themselves?
The study also emphasizes the need for patients to do their homework when choosing a hospital.
"I do think it's important for people to be choosy when they think about what hospital to go to," Bates says, adding that there are also measures that patients can take in order to safeguard their own health.
The Internet is also a useful tool at consumers' fingertips when it comes to selecting a hospital. Sites such as those sponsored by HealthGrades (http://www.healthgrades.com/), as well as the Leapfrog group (http://www.leapfroggroup.org/cp), allow potential patients to search for hospitals in their area and see how they stack up in terms of adherence to safety recommendations.
But Reed says the report is not intended to scare people away from the hospital. She says that in emergency situations or health crises, there is little question that the best place a person can be is at a medical center.
"They should not be afraid to go to the hospital," Reed says. "People who need help should certainly go to the nearest hospital."
But, she adds, patients must do their homework if they want to minimize their risk
"It is important, because of the differences between hospitals, that they do some research."
To further protect themselves, patients should always bring a list of the medications they are taking with them, and they should have someone else, such as a family member or a friend, accompany them to the hospital.
And, Reed says, they should be willing to take a stake in their own well-being.
"It really is important to do your research and become an active participant in your own health care," she says. "People need to make sure they are their own best advocates."