|
Patient-safety incidents edge up: HealthGrades
Story originally published April 4, 2006
Medicare patients experienced treatments from 2002 through 2004 that included 1.24 million patient-safety errors; 304,702 of those patients died and 250,246 of those deaths were deemed possibly preventable, according to a new survey released by the commercial healthcare data-tracking service HealthGrades.
The number of patient-safety incidents has climbed each year that Golden, Colo.-based HealthGrades has prepared patient-safety figures looking at three-year data-collection periods, the company said. The number of incidents rose from 1.14 million in the 2000-2002 period reported on in 2004, to 1.18 million in 2001-2003 reported on in 2005, and 1.24 million in 2002-2004 in the report this year. Patient-safety incident rates have gone up over the past three years, according to Samantha Collier, vice president of medical affairs at HealthGrades. In 2002, the rate was 3.02729%; in 2003, it rose to 3.10491%; and in 2004, it reached 3.15834%. The increases were statistically significant, Collier said.
"I think the conclusion, not just by me, but by most experts is, not much has changed," said Collier. "Some things have gotten better, some worse, but at the end of the day, we really haven't made the improvements that we need."
The analysis was based on incident rates for non-federal hospitals using 16 of the 20 Agency for Healthcare Research and Quality patient-safety indicators. The four omitted AHRQ metrics relate to obstetrics, data that do not match well with the Medicare MedPAR data set used in the study covering "virtually every hospital in the country," according to the study report, and excluding those in the Veterans Health Administration and the Military Health System.
HealthGrades also used 13 of the 16 indicators to calculate an overall patient-safety score and a ranking for each state and hospital. The 2002-2004 period of the latest study covered nearly 40 million hospitalizations.
"Wide, highly significant gaps in individual PSI (patient-safety indicator) and overall performance exist between the top and the bottom performing states," according to the report, with a 30-percentage-point gap in relative risk between the worst performing state, New Jersey, and the best, Minnesota.
Among those classified by HealthGrades as Distinguished Hospitals for Patient Safety, roughly the upper 5% of hospitals covered in the survey, patients experienced a safety-event occurrence rate nearly half that of patients at the bottom 15% of hospitals, the report said.
The most common PSIs were failure to rescue; decubitus ulcers, or bed sores; and post-operative sepsis. Failure-to-rescue rates improved 13% over the 2002-2004 period, but post-operative sepsis worsened by 25%.
The report notes that Minnesota was the first state to mandate public reporting of 27 National Quality Forum adverse events. The report lauds the state's Safest in America consortium of 23 hospitals comprising 10 hospital systems that "share data, highlight best practices and implement evidence-based, community-tested solutions."
Even though the data don't show improvement, Collier said, based on conversations with hospital leaders, patient-safety metrics are slowly catching on.
"I think the overwhelming majority of hospitals are embracing this information in their own efforts for quality improvement," Collier said. "We may not be seeing a change in the numbers, but we are seeing a change in attitude, and that is exciting."
"Until we can really look toward those best practices, put aside our ego, and look at those best hospitals and at Minnesota and say, what are they doing that's different, we just won't make those changes. From a policy and government standpoint, we have to look at that as well, whether that's pay-for-performance on some other program, that has to be addressed."
Report URL
---- Dr David G More MB, PhD, FACHI Phone +61-2-9438-2851 Fax +61-2-9906-7038 Skype Username : davidgmore E-mail: [EMAIL PROTECTED] |
_______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
