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Costs of Hospital Treatment Errors

By April 16, 2019Commentary

You are sick.  You need to be hospitalized for treatment.  While there, mistakes in care occur that make you sicker.  Happens all too frequently.  An analysis in Health Services Research estimates what the costs of those hospital treatment errors is.   (HSR Study)   In 2014 it was estimated that there 98 medical harms per 1000 hospitalizations.  Some are quite serious, like surgical site infections, falls and bed sores or pressure ulcers.  Most are fairly avoidable.  The authors used data from 2009-11 from AHRQ’s HCUP database to identify the frequency of such hospital care errors and to estimate the additional costs associated with them.  The database includes data from all hospitals in 12 states, across all payers.  They compared costs for patients who incurred a medical harm while hospitalized with costs for similar patients who avoided such harm.  Several common errors were examined, including catheter-related urinary tract and bloodstream infections; falls; surgical site infections; embolisms and thrombosis, severe pressure ulcers and birth trauma to the child or mother.

The most expensive harms were surgical site infections, central catheter-associated bloodstream infection and severe pressure ulcers, each of which was estimated to increase costs of an index stay by $26,000 to $32,000; or around 50% or more.  Only the birth-related harms had costs of less than $6000 or around 30% of total spending.  In addition, most of the errors were associated with substantially greater risk of readmission and of other spending after discharge.  The total impact to the system of these errors depends not only on the additional costs they incur, but their prevalence.  Hospital-associated urinary tract infections, for example, are fairly prevalent and are estimated to add over $2.5 billion in annual spending.  Nothwithstanding CMS’ and others efforts, hospital-associated medical harm occurs too frequently.  The pressure needs to be kept on through payment and other mechanisms.  We may not be able to get to zero, but we should be able to do better than we are.


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