Only Financial Penalties for Negligent Medical Providers Improve Patient Safety

The AHRQ reports that improvements in hospital acquired conditions has saved 50,000 patient lives from 2010 to 2013.  More can be done and financial incentives will pave the way.
The AHRQ reports that improvements in hospital acquired conditions has saved 50,000 patient lives from 2010 to 2013. More can be done and financial penalties/incentives will pave the way.

Recent headlines indicate that fewer Americans are dying from hospital errors.  The headline from U.S. Today read “50,000 Fewer Deaths Caused by Hospitals.”  That’s good news for patients.

However, it is not near enough.  Looking at the report from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ), it is clear that much more can be done.  The error rates, and resulting serious personal injuries and wrongful death associated with those errors, are still enormous and unacceptable.

Moreover, a cynic could find a number of issues related to motivations, past and present, for hospital action in preventing these errors.  In a nutshell, the improvements have not come through a sudden and spontaneous improvement in healthcare quality.  They have come because the financial incentives have shifted starting with Medicare non-payment penalties for certain hospital acquired injuries.

In any event, the error rates and resulting injuries and death remain commonplace.  If you or a loved one has suffered serious personal injury or wrongful death from a preventable medical error, the Albuquerque medical malpractice attorneys at Collins & Collins, P.C. can be reached at (505) 242-5958 for a free review of your case.

50,000 Lives Saved is a Good Start but Not Enough

50,000 lives saved over 3 years is about 17,000/year. In light of the estimated 400,000 deaths each year from preventable medical error, this is a good start but nowhere near enough.

The latest estimates suggest that up to 400,000 patients die each year as a result of preventable medical error.  Assuming this estimate was somewhat accurate, that means even after the improvements, 375,000+ patients will die each year despite the improvements.

The report from AHRQ states that there was a 17% reduction in hospital acquired conditions from 2010 to 2013.  This, according the report, means that 1.3 million fewer patients were harmed and 50,000 fewer were killed during this period.

However, the report states further that the rate of hospital acquired conditions is 121 per 1000 discharges suggesting 10% of all hospital patients experience one or more harms.  The report flatly states the obvious: “That rate is still too high.” 

Financial Incentives for Prevention of Medical Error

It is more than a little interesting that the cited improvements in medical error on the AHRQ report closely coincide with Medicare’s list of medical errors for which complications will not be reimbursed.

The improvements focused on in the AHRQ report are adverse drug events, catheter associated urinary tract infections, central line associated bloodstream infections, falls, obstetric adverse events, pressure ulcers, surgical site infections, and ventilator associated pneumonia.

Of these, only 2 (adverse drug events and obstetric events) are not on Medicare’s hit list.  They are all on the AHRQ’s list of never events.  This suggests a couple of things.

First, the medical errors were indeed preventable yet medical care providers neglected to take the action necessary to prevent them until Medicare’s financial incentives were put in place.  Secondly, additional financial incentives should result in further increases in patient safety.

Long List of “Never Events” Not on Medicare’s Hit List

Many “never events” are not on the Medicare target list meaning an event that should never happen along with its complications and costs are still compensated. This is hardly a financial incentive to do better.

It should be noted that Medicare’s list of non-compensable events is fairly short.  On the other hand, the AHRQ list of never events is quite extensive.  In short, far too many never events are not on Medicare’s list.

This would be a good starting point.  There are a number of never events that are debatable in terms of whether they should “never” happen.  However, there is a lot of room between rarely and never.

In any event, financial incentives clearly work.  It is no coincidence that the improvements have come on the heels of Medicare’s targeted events.  50,000 lives saved is a good start.  However, it’s far from enough when hundreds of thousands of innocent patients will continue to die each year as a result of preventable medical error.

Death by Preventable Medical Error Still at Epidemic Levels

Even with the improvements, preventable medical error remains the leading cause of accidental death in the U.S. It remains the 3rd leading cause of death overall trailing only heart disease and cancer.

This is unacceptable.  Patients and families deserve better.  Only when the costs of preventable medical errors outweighs the profits will we see a significant decline in these numbers!

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