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Cost of Medical Errors High, and Not Just in Dollars

Apr 9, 2008 | Parker Waichman LLP Medical errors—or patient safety incidents—are costing the federal Medicare program upwards of $8.8 billion.  Worse, in the period from 2004 through 2006, patient safety incidents resulted in 238,337 potentially preventable deaths according to HealthGrades' fifth annual Patient Safety in American Hospitals Study. HealthGrades analyzed 41 million Medicare patient records and discovered that that patients treated at top-performing hospitals had, on average, a 43 percent lower chance of experiencing one or more medical errors compared to the poorest-performing hospitals.

The overall incident rate was approximately three percent of all Medicare admissions evaluated, which accounted for 1.1 million patient safety incidents during the three years studied.  Effective October 1, the Centers for Medicare and Medicaid Services are scheduled to stop reimbursing hospitals for the treatment of eight major preventable errors, including objects left in the body following surgery and some post-surgical infections.  Given this, the financial implications for hospitals are substantial.

The HealthGrades study also identified hospitals with patient-safety incidence levels in the lowest five percent in the nation and found that Medicare patients who experienced a patient-safety incident during the study time frame, had a one-in-five chance of dying as a result of the incident.  Although the overall death rate among Medicare beneficiaries who developed one or more patient safety incidents decreased nearly five percent; however, four indicators—post-operative respiratory failure, pulmonary embolism or deep vein thrombosis, sepsis, and abdominal wound separation/splitting—increased.  Medical errors with the highest incidence rates were bedsores, failure to rescue, and post-operative respiratory failure, accounting for over 63 percent of all incidents. Bedsores and post-operative respiratory failure worsened during the study period.  Finally, of the 270,491 deaths that occurred among patients who developed one or more patient safety incidents, the vast majority—a staggering 238,337—were preventable.

If all hospitals performed at the level of Distinguished Hospitals for Patient Safety™, approximately 220,106 patient safety incidents and 37,214 Medicare deaths could have been avoided, saving the US about $2.0 billion during 2004 to 2006.  "While many U.S. hospitals have taken extensive action to prevent medical errors, the prevalence of likely preventable patient safety incidents is taking a costly toll on our health care systems, in both lives and dollars," said Dr. Samantha Collier, HealthGrades' chief medical officer and the primary author of the study.  "HealthGrades has documented, in numerous studies, the significant and largely unchanging gap between top-performing and poor-performing hospitals.  It is imperative that hospitals recognize the benchmarks set by the Distinguished Hospitals for Patient Safety are achievable and associated with higher safety and markedly lower cost."

The fifth annual HealthGrades Patient Safety in American Hospitals Study applies methodology developed by the US Department of Health and Human Services' Agency for Healthcare Research and Quality for identification of incident rates of 16 patient safety indicators among Medicare patients at virtually all of the nation's nearly 5,000 nonfederal hospitals.  HealthGrades applied this methodology using 13 patient safety indicators to identify the best-performing hospitals, or Distinguished Hospitals for Patient Safety™, representing the top five percent of US hospitals.

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