Medical error rate may be higher than IOM estimate

The number of medical errors per year may be twice as high as previously estimated, according to a new report. An average of 195,000 people in the United States died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient records released by HealthGrades, a health care quality company in Lakewood, CO.

The HealthGrades Patient Safety in American Hospitals study is the first to look at the mortality and economic impact of medical errors and injuries that occurred during Medicare hospital admissions nationwide from 2000 to 2002. The HealthGrades study finds nearly double the number of deaths from medical errors found by the Institute of Medicine’s (IOM) 1999 report conclusion, which found that medical errors caused up to 98,000 deaths annually and should be considered a national epidemic.

The 1999 IOM report, To Err is Human, extrapolated national findings based on data from three states; whereas, HealthGrades looked at three years of Medicare data in all 50 states and Washington, DC. This Medicare population represented approximately 45% of all hospital admissions (excluding obstetric patients) in the United States from 2000 to 2002, explains Samantha Collier, MD, Health-Grades’ vice president of medical affairs.

"The HealthGrades study shows that the IOM report may have underestimated the number of deaths due to medical errors and, moreover, that there is little evidence that patient safety has improved in the last five years," she says. "The equivalent of 390 jumbo jets full of people are dying each year due to likely preventable, in-hospital medical errors, making this one of the leading killers in the U.S."

HealthGrades examined 16 of the 20 patient-safety indicators defined by the Agency for Healthcare Research and Quality in Rockville, MD — from bedsores to postoperative sepsis — omitting four obstetrics-related incidents not represented in the Medicare data used in the study. Of these 16, the mortality associated with two, failure to rescue and death in low-risk hospital admissions, accounted for the majority of deaths that were associated with these patient safety incidents. These two categories of patients were not evaluated in the IOM analysis, accounting for the variation in the number of annual deaths attributable to medical errors, Collier notes.

"If we could focus our efforts on just four key areas — failure to rescue, bed sores, postoperative sepsis, and postoperative pulmonary embolism — and reduce these incidents by just 20%, we could save 39,000 people from dying every year," she says.