The oft-cited figure of 98,000 deaths per year comes from a report by the Institute of Medicine published in 1999. The newer report uses a collection of PSIs (patient safety indicators) recently developed by the Agency for Healthcare Research and Quality to screen hospital administrative data for incidents that should elicit concern for patient safety.
To arrive at the studys estimate, researchers first identified rates of PSI from records of about 37 million Medicare patients from 2000 to 2002, assessed how these incidents would affect mortality and cost in the same population, and then extrapolated to the general population. Excluding obstetric deaths (which would not have been reflected in the Medicare population), the researchers estimated that the patient safety incidents caused an additional $19 billion in in-patient costs and over 575,000 preventable deaths in the United States from 2000 to 2002.
Three PSIs accounted for nearly 60 percent of those assessed in the study: failure to rescue (i.e. failure to diagnose and treat in time), decubitus ulcer and post-operative sepsis. Three-quarters of the deaths attributable to patient safety incidents in the Medicare patients were due to failure to rescue and unexpected death in low-risk hospitalizations. These two categories were not included in the IOM analysis, according to the researchers.
The researchers say the problem of preventable medical errors is not addressed largely because it is sufficiently acknowledged. Blaming people instead of systems also contributes to the catastrophe, because unreported incidents keep flawed systems from being analyzed and improved. In addition, hospitals need more financing and other resources.
Better IT tools are only a minor part of the solution. The report states that "the commonly talked-about solutions to health cares broken system, computerized physician order entry system (CPOE) and electronic medical records, for example, will not be able to prevent the majority of patient safety incidents we identified as significant contributors to preventable deaths and excess costs each year."
Instead, the researchers say that hospitals should focus on what the study identified as main contributors to mortality: failure to rescue, decubitus ulcer, postoperative sepsis and postoperative pulmonary embolism/deep vein thrombosis.
The report was compiled by Health Grades Inc. and is available in pdf form.