In a recent analysis conducted by the U.S. Agency for Healthcare Research and Quality (AHRQ), American employers pay out $1.47 billion annually for costs related to potentially preventable errors in surgical patients.
AHRQ Drs. William E. Encinosa and Fred J. Hellinger estimated surgical error costs by analyzing data from a nationwide sample of over 161,000 adult patients who both underwent surgery in 2001 and 2002 and were enrolled in employer-sponsored benefit plans. The results were reported in the journal Health Services Research. The team also reviewed 14 potentially preventable errors divided into seven groups. These included technical problems, infections, pulmonary and vascular problems, acute respiratory failure, metabolic problems, wound problems, and events related to nursing care. Respiratory failure and infections were found to be particularly costly adverse events with insurers paying an additional $28,218 and $19,480 for a surgical patient who had respiratory failure or an infection, respectively. This was compared with costs for a similar patient without such complications. Other added costs included “$12,196 for episodes related to nursing care, $11,797 for metabolic problems, $7,838 for pulmonary and vascular problems, and $1,426 for wound problems.”
The team also found that about one in 10 deaths that occurred within 90 days of surgery originated from a preventable error; about one in three deaths occurred following initial hospital discharge. “Like the physical and emotional harm caused by medical errors, the financial consequences don’t stop at the hospital door,” AHRQ director Dr. Carolyn M. Clancy said in a related editorial. “Eliminating medical errors and their after effects must continue to be top priority for our healthcare system.”
Meanwhile, in April we reported that medical errors—or patient safety incidents—were costing the federal Medicare program upwards of $8.8 billion. Worse, in the period from 2004 through 2006, patient safety incidents resulted in 238,337 potentially preventable deaths according to HealthGrades’ fifth annual Patient Safety in American Hospitals Study. HealthGrades analyzed 41 million Medicare patient records. The overall incident rate was approximately three percent of all Medicare admissions evaluated, which accounted for 1.1 million patient safety incidents during the three years studied. Effective October 1, the Centers for Medicare and Medicaid Services are scheduled to stop reimbursing hospitals for the treatment of eight major preventable errors, including objects left in the body following surgery and some post-surgical infections. Given this, the financial implications for hospitals are substantial.
The HealthGrades study also identified hospitals with patient safety incidence levels in the lowest five percent in the nation and found that Medicare patients who experienced a patient safety incident during the study time frame, had a one-in-five chance of dying as a result of the incident. Also, four indicators—post-operative respiratory failure, pulmonary embolism or deep vein thrombosis, sepsis, and abdominal wound separation/splitting—increased. Medical errors with the highest incidence rates were bedsores, failure to rescue, and post-operative respiratory failure, accounting for over 63 percent of all incidents. Bedsores and post-operative respiratory failure worsened during the study period. Finally, of the 270,491 deaths that occurred among patients who developed one or more patient safety incidents, the vast majority—a staggering 238,337—were preventable.
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