An analysis of two well-controlled studies estimates that the number of preventable hospital-associated deaths are over 200,000 each year, argues a commentary in the Journal of Patient Safety.
In an online review, Dr. Kevin Kavanagh, the lead analyst, acknowledges that critics of such studies will say the data is flawed because they often include older and sicker patients.
However, he adds they also don't include diagnostic errors, deaths that occur after the patient goes home from the hospital, or don't include data about patients whose deaths are imminent. Thus, he concludes, the number of deaths in these studies are more often underestimated, not overestimated.
"The onus is on the facilities to provide better data," he said, adding that his analysis looked at the two studies with the most rigorous data sets.
"We calculated an annual rate of 163,156 preventable deaths and when combined with diagnostic errors, non-captured events and deaths after hospitalization can be projected to approximate 200,000 preventable deaths annually," Kavanagh, a retired physician and chairman of HealthWatch USA, said in an e-mail.
The report says that despite having the knowledge to prevent many adverse events, "many health systems do not adequately invest in patient safety to put well-known safety improvement strategies in place." The report offers as an example resistance to mandatory nurse-to-patient ratios, which have been proven to decrease falls, pressure sores, urinary tract infections and decrease medication errors.
"Advocates are not calling to prevent problems for which solutions are not known, but calling to implement known solutions to prevent all too common problems," the report says. "What ties the occurrence of preventable adverse events and mortality together is the willingness and determination of facilities to adopt a culture of safety and to invest in patient safety."
It also points out that data from countries with nationalized health care systems and "well-defined and near-uniform implementation standards" cannot be compared to the United States' combination of non-profit, for-profit and government-systems.
Kavanagh said that even if the preventable hospital mortality rate from medical errors "is not the 163,156 that we have projected, but is as low as the 25,000 per year based on the United Kingdom's NHS data, that equates to approximately 5 potentially preventable deaths per year, per hospital in the United States, or one every two to three months.
"In addition, one could argue that this figure should be doubled by accounting for deaths from diagnostic errors," Kavanagh writes. "In what other industry would such a record be tolerated, let alone defended? Would the airline industry and public ever tolerate even a single preventable airline crash? We can and must do better."
In an online review, Dr. Kevin Kavanagh, the lead analyst, acknowledges that critics of such studies will say the data is flawed because they often include older and sicker patients.
However, he adds they also don't include diagnostic errors, deaths that occur after the patient goes home from the hospital, or don't include data about patients whose deaths are imminent. Thus, he concludes, the number of deaths in these studies are more often underestimated, not overestimated.
"The onus is on the facilities to provide better data," he said, adding that his analysis looked at the two studies with the most rigorous data sets.
"We calculated an annual rate of 163,156 preventable deaths and when combined with diagnostic errors, non-captured events and deaths after hospitalization can be projected to approximate 200,000 preventable deaths annually," Kavanagh, a retired physician and chairman of HealthWatch USA, said in an e-mail.
The report says that despite having the knowledge to prevent many adverse events, "many health systems do not adequately invest in patient safety to put well-known safety improvement strategies in place." The report offers as an example resistance to mandatory nurse-to-patient ratios, which have been proven to decrease falls, pressure sores, urinary tract infections and decrease medication errors.
"Advocates are not calling to prevent problems for which solutions are not known, but calling to implement known solutions to prevent all too common problems," the report says. "What ties the occurrence of preventable adverse events and mortality together is the willingness and determination of facilities to adopt a culture of safety and to invest in patient safety."
It also points out that data from countries with nationalized health care systems and "well-defined and near-uniform implementation standards" cannot be compared to the United States' combination of non-profit, for-profit and government-systems.
Kavanagh said that even if the preventable hospital mortality rate from medical errors "is not the 163,156 that we have projected, but is as low as the 25,000 per year based on the United Kingdom's NHS data, that equates to approximately 5 potentially preventable deaths per year, per hospital in the United States, or one every two to three months.
"In addition, one could argue that this figure should be doubled by accounting for deaths from diagnostic errors," Kavanagh writes. "In what other industry would such a record be tolerated, let alone defended? Would the airline industry and public ever tolerate even a single preventable airline crash? We can and must do better."
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