Sixteen years ago, the Institute of Medicine Committee on the Quality of Health Care in America issued a blockbuster report highlighting the numerous opportunities for error in our complex health care system, To Err is Human: Building a Safer Health System. Today, medical error is the third leading cause of death in the US, according to a new analysis in the BMJ.
To be clear, doctors and other providers do not attribute death to medical error on death certificates. The Centers for Disease Control and Prevention (CDC) bases its analysis of the most common causes of death on death certificates completed by doctors, coroners and funeral directors. And, the form completed requires them to attribute death to a particular disease or ICD code. So, the CDC does not report non-disease related causes of death.
Yet, medical error can be the cause of death, speeding it up or ending life immediately. To ensure that research is undertaken to address patient safety and reduce the likelihood of medical error, death certificates should include medical error as a reason for death.
Medical error can happen for a variety of reasons. A medical provider can perform a procedure in an unintended way, or not follow through appropriately with or finish a procedure; or, the provider might choose the wrong intervention for a patient. The error can be at the patient level or the institution level.
Based on the best available data today, there are likely more than 400,000 in-hospital deaths each year from medical errors. This number does not include deaths from medical errors in an outpatient setting, the home, or a nursing home.
In 1999, the Institute of Medicine (IOM) reported that 44,000-98,000 people in the U.S. die from medical error each year, based on studies from 1984 and 1992. That’s a small fraction–between 11 percent and 25 percent–of the deaths from medical errors that the BMJ reports. In 2004, the Agency for Healthcare Research and Quality estimated some 195,000 deaths from medical error each year. More recently, the department of Health and Human Services Office of the Inspector General in 2008 reported 180,000 deaths in hospital from medical error for people with Medicare alone.
It’s not clear whether the number of deaths from medical errors is growing or whether the IOM significantly underreported the number of deaths resulting from medical error, as some later studies suggest. What is clear is that we don’t have a good handle on the total number of deaths from medical errors or their causes. We need to understand the causes of these errors in order to improve patient safety. And, whatever the number, it is way too high.
Here’s more from Just Care:
- Seven things to do before you or someone you love leaves the hospital
- Pay attention when someone you love leaves the hospital; the risk of harm is high
- To promote patient safety, hospitals and doctors should disclose more information
- Five questions to ask your doctor to avoid overtreatment
- How safe are outpatient surgery centers?