Unexpected Medical Problems Among Hospitalized Patients Decreased Significantly Over the Last 10 Years: Study

Despite the improvements, researchers say hospitals still have much to do to prevent unexpected medical problems and improve patient safety.

A comprehensive review of hospital adverse event data from the past decade shows that the rate of unexpected health problems among hospitalized individuals has decreased significantly. However, researchers warn that the frequency still provides a reminder about the serious impact medical mistakes can have, and call for further research to be conducted to better understand which trends represent a change patient safety.

Patient safety is a serious public health concern, and the World Health Organization estimates that as many as one in ten patients is harmed by problems during hospital care. It is estimated that over 50% of hospital injuries are preventable, with many attributed to unsafe medication practices and medication errors being the leading cause of avoidable harm.

In a study published this week in The Journal of American Medical Association (JAMA), researchers evaluated data from the Medicare Patient Safety Monitoring System from 2010 to 2019, to assess the rates of hospital adverse events, which are defined as any problem during care that results in an undesirable clinical outcome, which is not the result of the underlying disease or condition that required the hospitalization.

Researchers looked at data on 244,542 adult patients hospitalized in 3,156 US acute care hospitals from 2010 through 2019, including those diagnosed with acute myocardial infarction (17%), heart failure (17%), pneumonia (21%), and major surgical procedures (22%); and patients hospitalized from 2012 through 2019 for all other conditions (22%).

The findings suggest that total change in adverse events for those diagnosed with myocardial infarction decreased from 218 to 139 per 1000 discharges, from 168 to 116 per 1000 discharges for heart failure, from 195 to 119 per 1000 discharges for pneumonia, and from 204 to 130 adverse events per 1000 discharges for major surgical procedures. The rate of adverse events for all other conditions remained unchanged at 70 adverse events per 1000 discharges

One of the most notable decreases was the drop in adverse events caused by surgical procedures, which are often associated with surgical site infections (SSI) that cause tens of thousands of preventable deaths annually.

Researchers indicate that the findings are encouraging, but that further studies need to be conducted to evaluate which trends are the result of changes in patient safety.

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According to the U.S. Centers for Disease Control and Prevention (CDC), five percent of all hospital admissions result in a healthcare-associated infection, culminating in approximately 722,000 infections and 75,000 deaths each year as well as $28–33 billion in excess costs.

While overall the study found in-hospital mortality rates fell from 4.6% in 2010 to 2.7% in 2019, authors of an opinion piece challenged that additional safety procedures are needed, as none of the adverse event rates for adverse drug events, hospital-acquired infections, and general adverse events decreased more than fifty percent.

Medication errors are one of the most common forms of medical negligence and involve prescribing the wrong drug, the wrong dose, or failing to account for drug interactions. A 2022 study published in the National Center for Biotechnology Information, a branch of the National Institutes of Health (NIH) indicates 7,000 to 9,000 people die as a result of a medication error annually, while it is estimated that hundreds of events go unreported.

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