Guest post Ken Perez, vice president of healthcare policy, Omnicell.
On May 3, BMJ (formerly the British Medical Journal) published an analysis of prior research on medical errors by a team led by Dr. Martin Makary, a professor of surgery at Johns Hopkins University School of Medicine. Startlingly, the analysis concluded that more than 250,000 Americans die annually and nearly 700 perish daily from medical errors. Based on the Centers for Disease Control and Prevention’s (CDC’s) official list of the top causes of death, that figure would place medical errors as the third leading cause of death, behind only heart disease and cancer, which each took about 600,000 lives in 2014, and ahead of respiratory disease, which caused over 147,000 deaths.
The kind of medical mistakes that can be fatal range from surgical complications that go unrecognized to errors regarding the doses or types of medications administered to patients.
The Johns Hopkins analysis received widespread media coverage, with the New York Times, NBC News, NPR, Time, U.S. News & World Report and the Washington Post, among others, all reporting the study’s findings.
This is certainly not the first time that medical errors have attracted the attention of the mainstream media.
The Institute of Medicine’s landmark report, To Err is Human: Building a Safer Health System, released in November 1999, concluded that 44,000 to 98,000 Americans died each year because of preventable mistakes in hospitals. Moreover, the report estimated the annual costs of medical errors at $17 billion to $29 billion.
It was estimated that more than 100 million Americans were aware of the general conclusions of the IOM report, thanks to ample media coverage, which conveyed the idea that medical errors were more prevalent and costly than previously thought. Despite all the publicity about medical errors as a result of the IOM report, it would appear that the U.S. healthcare system is not any safer more than 16 years later.
No one knows the precise toll of medical errors, largely because the coding system used by CDC to record death certificate data does not capture items such as communication breakdowns, diagnostic errors, and poor judgment, all of which can cost lives.
In terms of the economic cost of medical errors, a study sponsored by the Society for Actuaries and conducted by Milliman in 2010 concluded that medical errors in 2008 cost the United States $19.5 billion—$17 billion (87 percent) of which was directly associated with added medical costs (inpatient care, ancillary services, prescription drug services, and outpatient care). The remainder was due to increased mortality rates and days of lost productivity from missed work, based on short-term disability claims.
Adjusting for the increase in the U.S. population from 2008 to 2016, the current year’s cost of medical errors is estimated at $20.8 billion.However, other authors have suggested that the economic impact is actually much greater. If one applies quality-adjusted life years (QALYs) to the 250,000 people who die each year from medical errors—and assumes an average of 10 lost years of life at $75,000 to $100,000 per year—the loss in QALYs for those deaths is $187.5 billion to $250 billion. To put that range in perspective, it represents 32 percent to 42 percent of the federal government’s outlays on Medicare this year.
Clearly, the publication of the Johns Hopkins study has reawakened our collective awareness of the problem of medical errors, and it should help bolster support for patient safety research, adoption of best practices, and development and application of technology solutions that prevent patient harm.