Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Medical-errors gap widens between best and worst hospitals: Healthgrades study

02.05.2005


- Three-Year Study Covers 37 Million Hospitalizations, Uses AHRQ Indicators -

- Nation’s Safest Hospitals, Identified in Study, Tend to Have "Culture of Safety" -

- Cost to Medicare of Patient Safety Incidents: $3 Billion Annually -



- Hospital-Acquired Infections Grow, Prove Costly -

Patient safety incidents at America’s hospitals increased slightly, but the nation’s safest hospitals grew even safer, resulting in a wider gap in patient safety incident rates among the nation’s best and worst hospitals, according to a new study of 37 million patient records released today by HealthGrades, an organization that evaluates the quality of hospitals, physicians and nursing homes for consumers, corporations, hospitals and health plans.

The second annual HealthGrades Patient Safety in American Hospitals Study finds that 1.18 million patient safety incidents occurred among Medicare hospitalizations in the years 2001, 2002 and 2003, with the cost to Medicare approaching $3 billion annually. That compares with 1.14 million incidents in the three years beginning with 2000.

The study also finds that hospital-acquired infections grew by 20% and accounted for 30% of the costs of patient safety incidents.

"The reason we see the hospitals with the lowest incident rates improving the fastest is that they have what I call a ’culture of safety’," said HealthGrades Vice President of Medical Affairs Samantha Collier, M.D., who authored the study. "A ’culture of safety’ requires rapid identification of errors and root causes and the successful implementation of improvement strategies, which can only be achieved with strong leadership, critical thinking, and commitment to excellence. For patients, it’s important to know which hospitals meet this standard, as they are nearly 50% less likely to have an incident at hospitals in the top 10%, according to the HealthGrades study."

The study, which applies 13 patient safety indicators (PSIs) identified by the Agency for Healthcare Research and Quality (AHRQ) to Medicare hospitalizations, produced the following findings:

  • There were wide, highly significant gaps in individual PSI and overall performance between the top10% and the bottom 10% ranked hospitals.
  • Top 10% hospitals generally had lower incident rates across all PSIs in 2001, but also generally improved at a greater rate than the bottom 10% hospitals between 2001 and 2003.
  • Overall, from 2001 through 2003, the best-performing hospitals as a group (hospitals that had the lowest overall PSI incident rates of all hospitals studied, defined as the top 10% of all hospitals studied) had 267,151 fewer patient safety incidents and 48,417 fewer deaths resulting in a lower cost of $2.3 billion associated with Medicare beneficiaries as compared to the bottom 10% of all hospitals studied.
  • Patients in the top 10% hospitals had, on average, on average 50 percent lower occurrence of experiencing one or more PSIs compared to patients at the bottom 10% hospitals. Important and frequent contributors to this notable difference were significantly lower rates of hospital-acquired infections and post-operative metabolic derangements.
  • If the bottom 10% hospitals improved only their hospital-acquired infection rates to the level of top 10% hospitals, 2,734 deaths associated with $792 million could have been avoided from 2001 through 2003.
  • The rates of six key quality improvement focus areas (metabolic derangements, post-operative respiratory failure, decubitus ulcer, post-operative pulmonary embolus (PE) or deep vein thrombosis (DVT), and hospital-acquired infections) worsened on average by 20 percent or more over four years (2000 through 2003), while another six PSIs (death in low mortality DRGs, failure to rescue, iatrogenic pneumothorax, post-operative hip fracture, post-operative hemorrhage or hematoma, and post-operative wound dehiscence) improved on average by less than 10 percent.
  • Of the total of 302,541 deaths among patients who developed one or more PSIs during 2001 through 2003, 81 percent (n=245,008) of these deaths were attributable to the patient safety incidents.
  • Hospital-acquired infections correlated most highly with overall performance and performance on the other 12 PSIs, suggesting that hospital-acquired infection rates could be possibly used as a proxy of overall hospital patient safety.
  • Hospital-acquired infections rates worsened by approximately 20 percent from 2000 to 2003 and accounted for 9,552 deaths and $2.60 billion, almost 30 percent of the total excess cost related to the patient safety incidents.
  • The 16 PSIs studied accounted for $8.73 billion in excess inpatient cost to the Medicare system over the three years studied, or roughly $2.91 billion annually.

"We found that that highest incidence rates were in the categories of Failure to Rescue, Decubitus Ulcer and Post-Operative Sepsis," continued Dr. Collier. "Since HealthGrades’ first Patient Safety study in 2004, which identified Failure to Rescue as a major source of patient safety issues, we were gratified to see the Institute for Healthcare Improvement advocate for -- and providers begin to adopt -- protocols for minimizing these events."

Distinguished Hospital Awards and Findings

Based on the study, HealthGrades identified 135 hospitals falling into the top 10% in the nation in terms of patient safety, qualifying them to receive the HealthGrades Distinguished Hospital Award for Patient SafetyTM. The award was designed to highlight hospitals with the best records of patient safety in the nation and to encourage consumers to research their local hospitals’ patient-safety records before undergoing a procedure.

Methodology

The study is based on 13 of AHRQ’s patient safety indicators, applied to the most recent MedPar file of Medicare admissions at nearly 5,000 hospitals covering 2001, 2002 and 2003. Teaching hospitals and non-teaching hospitals were evaluated separately, based on a recommendation from AHRQ that hospitals be compared to their peer group. All data was risk adjusted, so that hospitals with sicker patient populations could be compared equally with others.

The 13 AHRQ indicators are:

  • Death in low mortality Diagnostic Related Groupings (DRGs)
  • Decubitus ulcer
  • Failure to rescue
  • Foreign body left during procedure
  • Iatrogenic pneumothorax
  • Selected infections due to medical care
  • Post-operative hip fracture
  • Post-operative hemorrhage or hematoma
  • Post-operative physiologic and metabolic derangements
  • Post-operative respiratory failure
  • Post-operative pulmonary embolism or deep vein thrombosis
  • Post-operative sepsis
  • Post-operative wound dehiscence

The complete study and methodology can be found at http://www.healthgrades.com.

Scott Shapiro | EurekAlert!
Further information:
http://www.healthgrades.com

More articles from Studies and Analyses:

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

Im Focus: Quantum Sensors Decipher Magnetic Ordering in a New Semiconducting Material

For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.

Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...

Im Focus: Fast, convenient & standardized: New lab innovation for automated tissue engineering & drug

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...

Im Focus: Silencing bacteria

HZI researchers pave the way for new agents that render hospital pathogens mute

Pathogenic bacteria are becoming resistant to common antibiotics to an ever increasing degree. One of the most difficult germs is Pseudomonas aeruginosa, a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Molecular Force Sensors

20.09.2017 | Life Sciences

Producing electricity during flight

20.09.2017 | Power and Electrical Engineering

Tiny lasers from a gallery of whispers

20.09.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>