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Statistics on Healthcare Quality and Patient Safety Problems – Errors & Harm

Updated May 2014

On the heels of the “Dead by Mistake” articles in the news today, I’m once again having trouble finding a single consolidated referenced list of key healthcare safety and quality statistics, so I’m going to try to build that here. Will be updated frequently. If you have other statistics and sources to share, email me or post a comment.

How many patients die each year in the U.S. due to preventable errors?

Death numbers vary widely, depending on the study and methodology:

Between 44,000 and 98,000 Americans die each year in U.S. hospitals due to preventable medical errors (Institute Of Medicine, 1999).

195,000 Americans die a year due to preventable errors (HealthGrades, 2004)

32,500 patients die as a result of preventable medical errors in U.S. hospitals. The HHS number was lower than the IOM study because it only examined deaths resulting from 18 specific types of medical injuries. (U.S. Department of Health and Human Services, 2003)

An estimated 15,000 Medicare patients die each month in part because of care they receive in the hospital, says a government study released today –  44% of these were deemed preventable errors (Department of Health and Human Services report, 2008, via  USA Today).

In addition (conflicting numbers for infections, too):

99,000 patients die as a result of hospital-acquired infections (HAI) each year (CDC).

NOTE: Total deaths from errors and infections would be quoted as 99,000 plus one of the top three estimates.Hospital errors rank between the fifth and eighth leading cause of death, killing more Americans than breast cancer, traffic accidents or AIDS (IOM).Just one type of error—preventable adverse drug events—caused one out of five injuries or deaths per year to patients in the hospitals that were studied (AHRQ, 2000).

About 7,000 people per year are estimated to die from medication errors alone—about 16 percent more deaths than the number attributable to work-related injuries (Kaiser Family Foundation).

Investigators in a major study discovered that failures at the system level were the real culprits in over three-fourths of adverse drug events (AHRQ, 2000).

In nursing homes, infections contribute to 380,000 deaths per year, with costs reaching $2 billion.  (CMS data).


How many patients are injured?

Errors like these are responsible for preventable injury in as many as 1 out of every 25 hospital patients (4% of hospitalizations) (AHRQ, 2000).

About 18 percent of patients were harmed by medical care, some more than once… 2.4 percent — caused or contributed to a patient’s death, the study found.  (New York Times, 2010).  – this corresponds to 155,000 deaths per year

About one in seven Medicare hospital patients — or about 134,000 of the estimated 1 million discharged in October 2008 — were harmed from medical care. Another one in seven experienced temporary harm because the problem was caught in time and reversed.  (Department of Health and Human Services report, 2008, via  USA Today).

Approximately 1.14 million total patient safety incidents occurred among the 37  million hospitalizations in the Medicare population from 2000 through 2002 – 3.1% of hospitalizations (HealthGrades, 2004).

They concluded that 1% of patients were negligently injured (Harvard study, 1990).

At least 1.5 million Americans are sickened, injured or killed each year by errors in prescribing, dispensing and taking medications, the influential Institute of Medicine concluded in a major report (Washington Post, 2006).

Approximately 1.3 million people are injured annually in the United States following so-called “medication errors” (FDA)

One in five Americans (22%) report that they or a family member have experienced a medical error of some kind (Commonwealth Fund, 2002).

Adverse drug events occur in 6.5 of 100 non-obstetrical admissions. 28% of these were deemed preventable. (Referenced in JAMA, 2009)

Adverse events (of any kind) occur in 4% to 14% of all admissions. 50% to 70% are due to preventable error. (JAMA, 2009)

Wrong-site surgeries occur in 1 per 112,994 nonspine operations. (JAMA, 2009)

A 2005 survey of 1527 randomly-selected patients resulted in 34% reporting having experienced a medical error in the last two years. (JAMA, 2009)

  • 3% or more of hospital patients are hurt by medical error
  • 1 in 300 patients die from such mistakes
  • 24% of people say they or a family member have been harmed by medical error
  • 90,000 people die of hospital- ­â€acquired infections annually. More than half of these may be preventable. Healthgrades puts the number of preventable deaths at 200,000 annually.
  • 55% of recommended care actually gets administered.
  • $2,000 Annual cost to employers per insured worker due to poor- ­â€quality care
  • 61% of doctors wash their hands before examining a patient if they know someone is watching. Only 44% wash their hands if they think no one is watching.

What does this cost?

The IOM report estimates that medical errors cost the Nation approximately $37.6 billion each year; about $17 billion of those costs are associated with preventable errors. About half of the expenditures for preventable medical errors are for direct health care costs (IOM, 1999).

Medication errors cost the U.S. $4 billion a year (Institute of Medicine, 2007)

Annual cost of medical errors that harm patients to be $17.1 billion in 2008 dollars. (Milliman Inc study, 2011)

How do we know these are “preventable?”

Forty-four percent of the adverse events could have been prevented with appropriate attention (Department of Health and Human Services report, 2008)

One of the landmark studies on medical errors indicated 70 percent of adverse events found in a review of 1,133 medical records were preventable; 6 percent were potentially preventable; and 24 percent were not preventable.

A study released last year, based on a chart review of 15,000 medical records in Colorado and Utah, found that 54 percent of surgical errors were preventable:  http://www.ahrq.gov/qual/errback.htm

63.1 percent of the injuries were judged to be preventable (New York Times, 2010).


Is this just a problem in the United States?

The risk of dying in hospital as a result of medical error in the developed world is one in 300, Britain’s Chief Medical Officer warned   (Guardian, 2006).

One can estimate this risk of dying as a result of preventable medical error to be one in 361 in the United States based on 3.7% of hospitalizations having an adverse event, 13.6% of those lead to death (Brennan, Leape, et al, New England Journal of Medicine)  and about 55% of those are preventable (To Err is Human, Institute of Medicine). Doing the math on that = 1 /(.037 * .136 * .55) = 361 admissions for one preventable death due to medical error.

The official National Health Service (NHS) estimate of British patient deaths or serious injuries due to medical error is 11,000 cases a year (Parliament report, 2008).

In 2014, the NHS says the number is 12,500 British deaths per year (Nursing Times).

Almost 12,000 patients are dying needlessly in NHS hospitals every year because of basic errors by medical staff…  something went wrong with the care of 13 per cent of the patients who died in hospitals. An error only caused death in 5.2 per cent of these…  International evidence suggests one in 10 hospital patients suffers harm as a result of errors in their care… (London School of Hygiene and Tropical Medicine report, 2012)

Health Select Committee found that thousands of NHS mistakes are covered up and that a better estimate is that 72,000 patients die each year (The Sun, 2009).

Hospital infections kill 30,000 a year in Germany (The Local, 2011). Another study says, “Around 20,000 Germans die as a result of mistakes made in hospitals or clinics each year” (Source, 2014).

A comprehensive study in the Canadian Medical Association Journal found preventable medical errors contribute to between 9,000 and 24,000 deaths in Canada a year (CBC, 2004).

As many as 23,750 patients die each year due to “adverse events” (defined by researchers as “unintended injuries or complications resulting in death or prolonged hospital stay that arise from health care management.”)

  • About one in every 13 patients admitted to acute- care hospitals in Canada during fiscal year 2000 experienced one or more adverse events.
  • About 37 per cent of these errors were highly preventable.” in other words human error. (Canadian Medical Association Journal, 2005)

A Saudi government report puts the death by medical error rate at 0.05 percent per 100,000 people (how do we interpret that exactly??).

News report says that Germany has 17,000 deaths a year, based on a population about one fourth the size of the U.S. (UPI, 2010).

Bulgaria reports 7,000 deaths per year, with a population of just 7.6 million (Web, 2010).

“Official Australian government reports reveal that preventable medical error in hospitals is responsible for 11% of all deaths in Australia, which is about 1 of every 9 deaths. If deaths from properly researched, properly registered, properly prescribed and properly used drugs were added along with preventable deaths due to private practice it comes to a staggering 19%, which is almost 1 of every 5 deaths.” (Web, 2009).

New Zealand figures are very similar.

In The Netherlands, researchers estimate about 2,000 deaths per year from preventable adverse events (Web, 2009)

“Errors in medical care affect up to 10% of patients worldwide, reports the World Health Organisation, which has issued a list of patient safety solutions to avoid common medical errors.”

“At any one time, some 1.4 million people worldwide suffer from hospital-acquired infections, according to WHO figures.”


mark graban lean blog Statistics on Healthcare Quality and Patient Safety Problems   Errors & Harm leanAbout LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the VP of Innovation and Improvement Services for KaiNexus.

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  1. 5S says:

    My wife is a nurse and really this is huge in the industry and I think lean could help!

    195,000 Americans die a year due to preventable errors
    That sure is a lot of unneeded death

  2. Andy says:

    I am wondering if there are statistics on medical mistakes in different countries. Would a country with Universal Health Care have a better record or a worse record on this issue? I can see agruments for both sides. Medical workers who aren't distracted by worrying about bills and payment might do a better job at medicine. But then again, government workers are typically more lackidasical.

    Would a high tech tracking system help the situation? I would think so, it is was done right. It would also help doctors, i.e., say a car crash victim comes into emergency. If the victims medical history is immediately available, this could save his/her life.

  3. Mark Graban says:

    Medical errors are a major problem in the U.S., Canada, U.K, The Netherlands, etc. No single country has the operational problems taken care of.

    I haven't seen a single nurse distracted by billing or payment. The things that cause errors are bad processes, bad systems, bad management, bad organizational culture, etc.

    I think to generalize about "government workers" is not accurate or helpful. Many healthcare workers in the U.S. are technically "government workers" (county hospitals, etc.) and they care as much as anybody else, from my experience.

  4. Andy Teh says:

    Nice work! The numbers give us an idea of how unsafe healthcare really is, and they’re probably underestimates! Besides their absolute impact, you did a great job in highlighting the preventability of a large proportion of these “bad things” that occur. There are two ways of viewing this situation: (1) All this is unfortunate because things could have been done to avoid (unintentional) deaths and harm, and the emotional and financial burdens that accompany them; (2) We have the opportunity to prevent more deaths/harm by fixing the bad processes and systems, etc. that you so correctly pointed out.
    Andy Teh recently posted..Inference From a Sample MeanMy Profile

  5. Ed Casey says:

    Lean can work in hospitals. Its just an uphill battle unless you tackle the Culture, Communication, and Teamwork first. A hospital consist of many islands that do not consider how what they do impacts each other and ultimately the patient.

  6. The data can be confusing. If you count health care acquired infections then the numbers more than double for REPORTED medical errors. The reporting of medical errors in the unregulated American health industry is largely voluntary. The average hospital makes 10 medication errors per day. There are 3 wrong site surgeries each day in America.

    1 in 7 Medicare patients are injured while in a hospital.

    The problem is greed. Bad medicine creates more business. That may sound outrageous but it’s the only real explanation.

    • Mark Graban
      Twitter:
      says:

      You are right that data can be confusing (or outright inaccurate). Far too many patients are being harmed.

      But I think it’s completely inappropriate to use a term like holocaust or, as you do on your website, genocide.

  7. What would you call it?

    The massive loss of life due to the insatiable greed of the medical industry is a form of genocide. Hospital Acquired Infections alone kill twice as many Americans in one year than were killed in the entire Vietnam war.

    The biggest genocide in history was committed against the Hindus by the Muslims and that killed 80 million but that took 100 years. American medicine is killing at a higher and ever increasing rate. It is on pace with Hitler.

  8. Mark, are you feeding me softballs?

    The big pharma cartel is international. Glaxo Smith Kline is a major scoundrel as is Novartis. Johnson & Johnson has 200 factories in China and the FDA only has 2 inspectors in China. The carnage is worldwide.

    I was only speaking of medical industry induced deaths in the US and they only run neck and neck with the Third Reich but when you add all the deaths worldwide Hitler, Stalin, Mao and Pol Pot are a distant second. The data proves it.

    Estimates on Hitler’s holocaust vary but even at the highest estimates the medical industry is a bigger killer. They kill more every day than Hitler killed in his heyday. Hitler killed about 2 million a year on average. The medical industry has been doing that for much much longer.

    Actually comparing the evil of the medical industry to Hitler is an insult to any possible shred of humanity Hitler may have had. Even Hitler would have protected the German people from a medical industry like the one we have. Let me put it another way. Let’s say I call the medical industry a bunch of greedy pigs. That would be an insult to swine everywhere.

    Everything on Medical Holocaust is documented and sourced. If you read just a few of the articles Mark I think you will see the light. Yes Mark, the medical industry IS more evil than the Third Riech, Stalin’s Purge ect…

    • Mark Graban
      Twitter:
      says:

      Honestly, with your line of discussion, you’re going to come across as unhinged and not get anyone to take you seriously. Get a grip. I’m not feeding you softballs, I’m criticizing your choice of words… I’m starting to think you are just “trolling” as they say on the web.

  9. What’s the death toll? Who killed more people? Hitler or the Medical industry?

    When a family member of yours is killed by a drug or a medical error I doubt if you will be in the mood to play semantics or word games but since you insist in doing it here let’s define some words.

    Holocaust: any mass slaughter or reckless destruction of life.

    What the medical industry is doing is a holocaust.

    To anyone reading this you probably know more than one victim of a medical error or dangerous prescription drug.

  10. The deaths caused by the medical industry are intentional in that bad medicine is far more lucrative than good medicine. Most hospital acquired infections are preventable. Hospital infection net big $$$$ for the medical industry. Google Death By Medicine and you will see how much revenue comes from hospital infections. Based on a voluntary reporting system there are 2 million each year. That adds a week to most hospital stays.

    There is no financial incentive to practice good medicine but there are many financial incentives to make people sick and exploit disease.

    If it were only a few infections or a few errors or a few adverse drug reactions I would say that it is not intentional but it is millions. In the case of infections the fact that they are still increasing tells me that the industry does not want to prevent them. The Pronvonost protocol will eliminate nearly all nosocomial infections.

    http://en.wikipedia.org/wiki/Peter_Pronovost

    The medical holocaust in the US in not an accident. The medical profession became a business and then a corporate run industry run by people like Mitt Romney and as a result millions of Americans are killed and maimed. The US has the worst health care in the industrialized world and the most expensive.

  11. Robert says:

    The citation on the Guardian story are wrong. Britain’s ‘top doctor’ (whatever that is) didn’t report a 1 in 300 fatality rate in the UK. He said ‘the developed world.’ There’s no specific figure for the UK in that report.

  12. Thanks for posting, Mark. Such information should be available nationally along with quality and cost information for local healthcare providers. It’s easier to access quality and cost info for tree contractors than hospitals.

  13. Cruz R. Gomez says:

    In the late 1960′s while getting a lesson on statistics in an engineering economics class at CSULB the professor stated that some time in the past there had been a long term work stoppage by doctors and that during this period of time the death rate of patients decreased noticeably. An assessment as to the decrease in deaths can be easy to analyze, i.e,; no infections from the dirty hands of doctors that are not required to use sanitary procedures in their profession, no mistakes in the filling of prescriptions or in following doctors’ orders due to ineligible writing ( a practice that was handed down by witch doctors in order to create an aura of mysticism for the ordinary persons), no treatment of patients by doctors that have no concern for the welfare and good care of patients, no treatment of patients by doctors that are hooked on use of illegal drugs, no harm to patients by intentional harmful actions of doctors, etc.

  14. Statistics relating to health and diseases are rather crude( measurement taken from data collected without strict criterion ) Inappropriate management of cases occur both in private and gov run health services. In my opinion more so in the private sector because of financial motives. The public are hoodwinked with all sorts of claims by treatment strategies with dubious clinical benefit leading to demand led service than need based service as it should be.
    I hope to continue to educate the lay public through my website to exercise caution in jumping on to the wagon of misinformation.

  15. Michel Archange says:

    It is quite surprising to me that in a country where we spend twice more than in any developed country for our health care services, we got twice or even three times more deaths due to medical errors. Why this is happening? I don’t think we should blame this on physicians!!! Deming, the father of quality management, said, “85% of errors introduced into a process are result of problems with the system rather than the type of random errors and mistakes introduced by individuals.” This a major issue for hospitals and the entire health care industry as a whole. The good news, as it has been mentioned, is that hospitals are increasingly adopting quality improvement approach to tackle this issue. All the hospitals should be required to adopt a continuous quality improvement approach of their choice (Lean, Six Sigma, TQM) as a strategic priority and allocate necessary resources for its implementation. The time for Change is now.

  16. Paul Everett says:

    One of the problems with these statistics, as uncertain but still very concerning as they are, is that they just give the raw numbers of those harmed or whose death might be attributed to a medical error. What isn’t shown is the percentage of patients served who experience this regrettable event. It may be very low compared to the opportunity for error. (On-error training covers this issue). We simply don’t know. What is the error rate (%) for postal mis-deliveries, lost letters, etc.? Out of the billions processed, I’m betting it is small. I suspect something similar in medicine but probably higher because the types of errors have larger consequences and the venue in which errors occur is much ‘messier’, so to speak. Can’t think of how to say “more risky” but it truly is.

    Mark, the comments above from the rabid person is a good argument for moderating your board. I read one and skipped all the rest. Kinda scary that minds are out there like that and they may even vote!!

  17. Paul Everett says:

    On 94% of errors due to the process: That may be true but….it is the physicians that largely control the process. My wife is involved in work to reduce MRSA in several hospitals (very successfully, btw) and the biggest problem is cultural. The Docs don’t like to be told to gown and glove, wash hands, etc. So, they continue THEIR process, which results in patient harm. Thus, to blame the process is only part of the story and may be used to excuse poor doctor protocol following. We have the protocols, the problem is OUR DOCS DON’T FOLLOW IT.!!

    • Mark Graban
      Twitter:
      says:

      Paul – I was at a Lean IT conference last week and there were interesting conversations where people were challenging the Deming theory that 94% of problems are caused by the system. They wondered if that was only true in a manufacturing system. I’m not sure… interesting idea.

      Doctors have far more freedom than the typical manufacturing worker. Doctors have more choices about how they act and what they do. They also have a greater responsibility given the importance of their work.

      When I worked at GM, when workers were pressured to focus on quantity over quality, they had very little ability to speak out or take actions against the bad system (and bad leadership) that was thrust upon them.

      If a doctor is being pressured into cutting corners (the O.R. is way behind schedule, so get on with your work), they have the ability and political power to say, “NO! I’m going to not rush and I’m going to do things the right way for the patients.”

      So I’m more wiling to blame an individual when they are in a place of higher political or organizational power (such as a doctor or a CEO) as compared to a nurse or a member of housekeeping staff.
      Mark Graban recently posted..“Healthcare Kaizen” Public Workshop – June 25, Dallas / Fort WorthMy Profile

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