Almost One Million Safety Incidents in Medicare Patients

In-hospital incidents in three-year period result in 99,180 deaths, $8.9 billion in excess costs
By Jeff Muise
HealthDay Reporter

THURSDAY, April 1 (HealthDay News) -- There were almost a million safety incidents among more than 900,000 hospitalized Medicare patients from 2006 to 2008, leading to nearly 100,000 in-hospital deaths, according to the March 2010 HealthGrades Seventh Annual Patient Safety in American Hospitals Study.

Rick May, M.D., of the health care ratings organization HealthGrades, and colleagues reviewed 39.5 million Medicare hospitalization records from the country's nearly 5,000 nonfederal hospitals. The researchers evaluated the patient safety incidents against indicators developed by the Agency for Healthcare Research and Quality, tracked trends over the study period, and identified hospitals with safety records in the top 5 percent (HealthGrades 2010 Patient Safety Excellence Award recipients).

The report notes that there were 958,202 patient safety incidents affecting 908,401 Medicare beneficiaries. These numbers represented 2.29 percent of the total Medicare admissions, resulted in 99,180 in-hospital deaths, and were associated with $8.9 billion in excess costs. The most common safety incidents were related to (with rates per 1,000 patients): failure to rescue (92.71), decubitus ulcer (36.05), postoperative respiratory failure (17.52), and postoperative sepsis (16.53). Over the three-year study period, there was improvement in six safety indicators -- complications of anesthesia, failure to rescue, selected infections due to medical care, postoperative hemorrhage or hematoma, postoperative abdominal wound dehiscence, and accidental puncture or laceration -- while eight indicators worsened -- bed sores, collapsed lung, hip fracture, lung blood clots, leg blood clots, postoperative physiologic/metabolic derangements, sepsis, and transfusion reaction. The worsened indicators accounted for 78.94 percent of the safety incidents.

"If all U.S. hospitals had performed at the same level as the Patient Safety Excellence Award hospitals, the U.S. health care system could have saved nearly $2.1 billion and potentially prevented 22,590 deaths in just three years among Medicare cases alone," the authors write.

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