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Reduction of Hospital-Acquired Conditions

By December 13, 2016December 14th, 2016Commentary

It seems odd that when you go to get health care you might have to be worried about something happening that makes your health worse, but doctors and clinicians are not perfect and they make mistakes and health care setting environments aren’t free of the usual dangers of infectious agents and safety hazards.  So health care receipt-associated conditions has been a focus.  The Institute of Medicine issued a seminal report on patient safety, which led to multiple initiatives to try to reduce the incidence of health care-associated medical conditions, including a number by Medicare.  Hospitals have been a specific focus and a new report from the Agency for Healthcare Research & Quality indicates that progress is being made.   (AHRQ Report)   These conditions include infections, adverse drug events, falls, pressure ulcers and thromboembolisms.  Since 2010 the rate of these hospital-acquired conditions has fallen significantly, from 145 per one thousand discharges in 2010 to 115 per thousand discharges in 2015, or a 21% decline over that time.

This is 3.1 million fewer hospital-acquired conditions than would have occurred if the 2010 rate had held steady.  The agency estimates that 125,000 fewer hospital deaths resulted over this period and $28 billion in health care costs were saved.  Fewer adverse drug events accounted for 42% of the total decline in incidents; fewer pressure ulcers 23%, less catheter-associated urinary tract infections 15% and fewer falls for 10%.  Looked at individually, there was a 91% decline in central-line associated bloodstream infections, which are relatively less frequent, but very dangerous, and a 76% reduction in post-operative venous thromboembolisms, which are similarly infrequent but dangerous.  Adverse drug events are much more common, and declined by 29%, while pressure ulcers, the second-most common condition, declined only 10%.  Overall, there appears to be less risk to a patient in being hospitalized, the only caveat being that it may be that since hospitals are now often being penalized for the occurrence of these conditions, they may be more creative in not reporting them or not describing their cause as being related to being hospitalized.

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