A hospital is a place of healing. It can also be a place of injury. In the U.S., 2.9% of people who enter the hospital are actually harmed by the care they receive. Yet what are the costs of these injuries?
A paper by Encinosa and Hellinger (HSR 2008) attempts to estimate the cost of hospitals failing to prevent advser medical outcomes. The authors examine 14 patients safety indicators (PSIs) such as: anesthesia complication, accidental laceration, foreign body left in, iatrogenic pneumothorax, transfusion reaction, infections due to medical care, sepsis, pulmonary embolism and deep vein thrombosis, acute respiratory failure, physiologic and metabolic derangements, hemorrhage/hematoma, wound dehiscence, postoperative hip fracture and decubitus ulcer.
The authors found the following results:
“Excess 90-day expenditures likely attributable to PSIs ranged from $646 for technical problems (accidental laceration, pneumothorax, etc.) to $28,218 for acute respiratory failure, with up to 20 percent of these costs incurred postdischarge. With a third of all 90-day deaths occurring postdischarge, the excess death rate associated with PSIs ranged from 0 to 7 percent. The excess 90-day readmission rate associated with PSIs ranged from 0 to 8 percent. Overall, 11 percent of all deaths, 2 percent of readmissions, and 2 percent of expenditures were likely due to these 14 PSIs. ”
- Encinosa WE, Hellinger FJ (2008) “The Impact of Medical errors on Ninety-Day Costs and Outcomes: An Examination of Surgical Patients” Health Services Research, v43(6): 2067-2085.