U.S. Hospitals Called No Better on Patient Safety
By Katrina Woznicki, MedPage Today Staff Writer
Reviewed by
Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine
May 03, 2005
Also covered by:
ABC News, MSNBC
MedPage Today Action Points
- Patients reading news stories about this study may ask about the safety of local hospitals. Discuss patient safety concerns with patients and refer them to hospital administrators for more information about institutional safety records.
- Patients should understand that while these models may be valuable in identifying hospitals that perform better than others, one should not use this information alone to determine the quality of care provided at each hospital.
Review
GOLDEN, Colo., May 2-Hospitals are still dangerous places in the 21st century, perhaps even more dangerous than before, according to a national assessment of inpatient safety.
The bottom line of a report, released by Health Grades Inc., a private health care quality assessment company, was a net deficit in patient safety in hospitals despite improvements in certain areas.
Essentially, there was a 10% improvement in six of the 13 areas of safety assessment, but a 20% decline in six others, said the report, called
HealthGrades Patient Safety in American Hospitals Study. One area didn't change.
The report rated safety but not clinical excellence at hospitals. The lead author was Samantha Collier, M.D., the company's vice president of medical affairs.
In the first three years of the century there were 1.18 million incidents in which hospitalized patients were injured as a result of medical accidents or errors, according to the report.
The areas of improvement included reduction in the number of deaths in "low mortality" DRGs; iatrogenic pneumothorax, and post operative hip fracture. The declines in quality included decubitus ulcers, postop respiratory failure, and postop pulmonary embolus or deep vein thrombosis.
Additionally, hospital-acquired infections jumped 22.5% from 2000 to 2003, claiming 9,552 lives and costing $2.60 billion. During the same period, the postop sepsis rate increased by 20%.
The report also pointed out a widening gap between the nation's best hospitals and its worst hospitals. Hospitals in the top 10% are on average 50% less likely to have an incident, according to the study.
When compared with the worst performing hospitals, the top-tier medical facilities had 267,151 fewer patient safety incidents, and 48,147 fewer deaths, resulting in reduced overall costs of $2.3 billion associated with Medicare beneficiaries. One hundred thirty five hospitals across the United States ranked in the top 10%, according to the report.
HealthGrades identified both teaching and non-teaching hospitals in the top 10% as best performing. These 135 hospitals represent 3% of the total hospitals evaluated.
The study found that if the bottom 10% of hospitals had improved their hospital-acquired infection rate to the levels of the top-tier 10% hospitals, an estimated 2,734 deaths between 2001 and 2003 could have been prevented and $792 million could have been saved.
"We found that that highest incidence rates were in the categories of failure to rescue, decubitus ulcer, and post-operative sepsis," Dr. Collier said.
Primary source: HealthGrades Second Annual Patient Safety in American Hospitals Report. May 2005 by Health Grades, Inc.
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