Tuesday, November 16, 2010

Hospital care fatal for some Medicare patients - USATODAY.com

An estimated 15,000 Medicare patients die each month in part because of care they receive in the hospital, says a government study released today.

The study is the first of its kind aimed at understanding "adverse events" in hospitals — essentially, any medical care that causes harm to a patient, according to the Department of Health and Human Services' Office of Inspector General.

Patients in the study, a nationally representative sample that focused on 780 Medicare patients discharged from hospitals in October 2008, suffered such problems as bed sores, infections and excessive bleeding from blood-thinning drugs, the report found. The federal Agency for Healthcare Research and Quality called the results "alarming."

"Reducing the incidence of adverse events in hospitals is a critical component of efforts to improve patient safety and quality care" in the U.S., the inspector general wrote.

The findings "tell us exactly what some of us have been afraid of, that we have not made much progress," said Arthur Levin, director of the independent Center for Medical Consumers and a member of an Institute of Medicine committee that wrote a landmark 1999 report on medical errors. "What more do we have to do to make sure that sick people can rest assured that they're not going to be harmed by the care they're getting?"

Among the findings in the report obtained by USA TODAY:

•Of the 780 cases, 12 patients died as a result of hospital care. Five were related to blood-thinning medication.

Two other medication-related deaths involved inadequate insulin management resulting in hypoglycemic coma and respiratory failure resulting from oversedation.

•About one in seven Medicare hospital patients — or about 134,000 of the estimated 1 million discharged in October 2008 — were harmed from medical care.

•Another one in seven experienced temporary harm because the problem was caught in time and reversed.

About 47 million Americans are enrolled in Medicare, a government health insurance program for people 65 and older and those of any age with kidney failure.

The adverse events found in the study weren't necessarily due to medical mistakes, said Lee Adler, a University of Central Florida medical professor who was involved in the study. For example, he said, an allergic reaction to a penicillin injection is an adverse event, but it's a medical error only if the patient's allergy was known prior to the shot.

Among the problems identified in the report were Medicare patients who had excessive bleeding following surgery or a procedure. For example, one patient had excessive bleeding after his kidney dialysis needle was inadvertently removed, which resulted in circulatory shock and an emergency insertion of a tube to allow breathing.

When the tube was removed the next day, the patient inhaled foreign material into his lungs and needed lifesaving medical help, the report said.

Peter Pronovost of Johns Hopkins University, co-author of the book Safe Patients, Smart Hospitals, said medical mistakes are "an enormous public- health problem."

"We spend two pennies trying to deliver safe health care for every dollar we spent trying to develop new genes and new drugs," Pronovost said. "We have to invest in the science of health care delivery."


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