Updated April 10, 2013
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 errorâ€”preventable adverse drug eventsâ€”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 aloneâ€”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 â€” 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 â€” or about 134,000 of the estimated 1 million discharged in October 2008 â€” 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?
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).
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).
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.”
About 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.