US hospitals are safer for patients than a decade ago, but more work remains: study – The Hill

Adverse events in hospitals — harm that comes from medical care rather than underlying disease — can range from surgery complications to infections and are a source of concern for many who may have to be admitted. 

But new research published in the Journal of the American Medical Association this week shows that between 2010 and 2019, U.S. hospitals saw a significant reduction in these events due in large part to widespread efforts aimed at improving patient safety.

Medical records from more than 244,000 patients were included in the analysis, making it the largest medical records-based study on adverse events to date. The cohort represented a total of 3,156 hospitals throughout the country. 

The Medicare Patient Safety Moderating System (MPSMS) was employed to document 21 in-hospital adverse events with particular focus on heart attacks, heart failure, pneumonia and major surgical procedures.

Data showed that between 2010 and 2019, rates of events related to heart attacks decreased from 218 to 139 per 1000 hospitalizations; from 168 to 116 for heart failure; from 195 to 119 for pneumonia; and from 204 to 130 for complications relating to major surgeries, respectively.

Similar declines were also found among patients admitted for all other reasons between 2012 and 2019. Findings were consistent regardless of patient age, sex, ethnicity, race, comorbidities and hospital characteristics. 

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“Our data shows that the major safety improvement efforts made by our country and our hospitals seems to be paying off,” said study co-author Mark Metersky of the University of Connecticut School of Medicine in a press release. 

Greater improvements in adverse event rates were seen among older patients, while those who did experience an event were more likely to have longer hospital stays and higher mortality rates. Authors noted more research is needed to better understand to what extent these findings translate into improved patient safety. 

The majority of adverse events that occur in hospitals are not a result of physicians intending to hurt patients, but rather occur due to a lack of safety technology innovations, limited infrastructure and other systemic problems, explained William V. Padula and Peter J. Pronovost in an accompanying editorial.

However, the authors also cautioned statistical significance may not adequately reflect real-world improvements in patient care. 

“Bold reforms are needed through measurement, payment, and hospital reorganization to achieve clinically meaningful outcomes,” Padula and Pronovost wrote. “These changes will not occur until health systems acknowledge they are failing to first do no harm, and that each reported adverse event represents potential morbidity or mortality for individual patients.”

Published on Jul. 13, 2022