Is Poor Hospital Care Causing One-Sixth of U.S. Deaths?

The Journal of Patient safety recently released a study concluding that between 210,000 to 440,000 patients die each year from suffering preventable harm in U.S. hospitals. If accurate, this would make medical errors the third-leading cause of death in the U.S., behind only heart disease and cancer, and could constitute nearly one-sixth of all U.S. deaths.

John T. James, a NASA toxicologist and head of the advocacy organization Patient Safety America, developed this recent study’s estimates based on prior research done using the Global Trigger Tool (GTT), which guides reviewers through medical records to help calculate and quantify preventable harm caused to patients. After applying the findings of four separate studies that used the GTT to 34 million hospitalizations in 2007, James deduced that 210,000 patients die annually from preventable errors. However, James noted how the GTT fails to register harm “in several types” of cases, and reasoned that the annual death toll could actually be well over 400,000. James also determined that serious, non-fatal harm was 10-20 times more common than lethal harm, meaning that close to 8 million Americans could be suffering serious preventable harm due to medical errors each year.

Not surprisingly, there is quite a bit of contention between patients’ safety experts on what the real numbers are and whether they can even be accurately determined, at this point. Many argue that medical records are often plagued with inaccuracies because providers are reluctant to report mistakes. The American Hospital Association has said they have more confidence in the findings of the Institute of Medicine’s study done in 1999, which concluded that 98,000 people die each year from mistakes in hospitals, and which is often the figure quoted in current discussions of medical negligence. Candidly, however, chances are very good that the Institute of Medicine number is too low.

The very fact that hospitals admit their record-keeping isn’t the best lends, all on its own, to suggest that these sorts of medical errors are under-reported. For example, the Office of Inspector General for Health and Human Services estimated in 2010 that, among only Medicare patients, the number of deaths related to poor hospital care could be as high as 180,000. That makes James’ estimate of 210,000 to 440,000 deaths across all patient groups sound plausible.