The number of Americans dying prematurely each year from preventable adverse events in hospitals, including hospital acquire infections, reaches into the hundreds of thousands. Based on data published by the Office of the Inspector General of the Department of Health and Human Services and data published in peer-reviewed medical journals, I have published an estimate that preventable adverse events in hospitals contribute to the deaths of 440,000 Americans each year. My study was published in the Journal of Patient Safety in September, 2013. My estimate is well above others because I have included errors of omission (failure to follow guidelines), errors not apparent in medical records, errors of communication, and diagnostic errors. This estimate places the annual death rate from suboptimal hospital care as the third leading cause of death behind heart disease (650,000) and cancer (550,000), and well ahead of cerebral-vascular disease (160,000). Obviously, there can be multiple causes of death at work, but the contribution from preventable events is appalling. Below are some findings from published studies:
- It takes 15 years for a new medical discovery to be used by half the clinicians. Balas and Boren (2000) studied the average rate of increase in use of 9 clinical procedures based on landmark studies and found that the average rate of increase in use was 3.2% per year, thus 15.6 years were required on average for 50% implementation.
- It took 25 years (1982-2007) for cardiologists to bring the prescribing of beta-blockers to full use in heart patients that needed them to live.
- Cardiologists hide medical errors. An article surveying the professionalism of doctors by specialty found that almost 2/3rds of cardiologists admitted that they had recently refused to report a serious medical error that they had direct personal knowledge of to any authority (Campbell, et al., 2007).
- Medical records are poor quality based on a study of records on hospitalized heart patients. The grade using a standard tool was 62%-failing in most systems (Dunlay et al. 2008)
- The medical records of 1000 hospitalized patients were reviewed for medical errors and patients were interviewed about medical errors. Three times more serious medical errors were known by patients compared to the number recorded by doctors in medical records (Weismann, et al. 2008).
- Medical specialists are not required by any law to study or demonstrate competency in their specialty after their initial medical training. In Texas the law requires 24 hours per year of continuing medical education, but there is no requirement that physicians take that in their specialty. The Texas Medical Board does random checks on 1% of physicians in Texas each year to determine if they have done any CME. Five states have no requirement for CME. Check here to find out if your state is one of them: http://www.ama-assn.org/ama1/pub/upload/mm/40/table16.pdf
- The American Board of Internal Medicine gave lifetime board certification in cardiovascular disease until 1990. Cardiologists board certified before that year have been grandfathered, which means they do not have to do anything to maintain board certification. In 2005 more than half of all cardiologists enjoyed this status as board-certified for life and refused to participate in voluntary maintenance of certification.
- The US ranks 19th of 19 developed countries in deaths preventable by adequate healthcare in persons under 75 years of age. Approximately 330,000 deaths occur prematurely in the US simply because of failures of the healthcare industry. The death rate in France [the best-performing developed country] is approximately half of ours.
- The first-year infant mortality rate in the US ranks us 42nd of all countries as reported by the United Nations in 2009. There is no developed country with a higher infant mortality rate than ours. If our infant mortality in the first year of life were as low as that of Japan, then 16,000 more American babies would live each year.
- The rate of maternal mortality (death associated with childbirth) in the U.S. ranks us 39th among all countries of the world (Lancet, 2010).
- Patient safety is not improving – based on a report in the 24 November 2010 New England Journal of Medicine, the number of medical errors in North Carolina hospitals did not decrease from 2002 to 2007.
- I have been told by a past president of the American Board of Medical Specialties that patients know no more than 1 % of the medical errors that happen to them.
- The US health care industry costs us about twice as much per person as any other major healthcare system in the world.
- Visit this link to a congressional report by three physicians on the hundreds of unnecessary heart surgeries that were done in California under the noses of the regulatory organizations. It took the FBI to break up the fraud and incompetence. Peer review within the hospital had failed.
- Excessive patient deaths are a concern of the World Health Organization. To see WHO patient safety, click here. To see WHO comments on the US medical system, click here. Look at the 7th and 8th paragraphs.
- The Commonwealth Fund ranks states according to quality of healthcare available to children. Texas ranks 46th among the states and DC in healthcare quality (Mitka, 2008).
- Before you take a drug: Questions to Ask Your Doctor or Pharmacist
- Check out surgeon complication rates on ProPublica:https://www.propublica.org/article/surgery-risks-patient-safety-surgeon-matters?utm_campaign=sprout&utm_medium=social&utm_source=twitter&utm_content=1436848408
- A site to help patients gain best healthcare, GWU’s Guide to Preventable Harm: What You Should Know About Preventable Harm – Blog
