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Injuries in hospitals pose a significant threat to patients and substantially increase health care costs

Medical injuries during hospitalization resulted in longer hospital stays, higher costs, and a higher number of deaths in 2000, according to a new study from the Agency for Healthcare Research and Quality. The study used AHRQ's Patient Safety Indicators and data from the Healthcare Cost and Utilization Project's National Inpatient Sample to identify medical injures in 7.45 million hospital discharges from 994 acute care hospitals across 28 States in 2000.

Researchers led by Chunliu Zhan, M.D., Ph.D., of AHRQ's Center for Quality Improvement and Patient Safety, found that the impact of medical injuries varies substantially. Postoperative bloodstream infections had the most serious consequences, resulting in hospital stays that were nearly 11 days longer than normal, added costs of $57,727, and an increased risk of death after surgery of 21.9 percent. Based on these data, researchers estimate that 3,000 Americans die each year from postoperative bloodstream infections. The next most serious event was postoperative reopening of a surgical incision, with 9.4 excess days, $40,323 in added costs, and a 9.6 percent increase in the risk of death. This equates to an estimated 405 deaths each year from reopening of surgical incisions. Birth and obstetric trauma, in contrast, resulted in little or no excess length of stay, cost, or increase in the risk of death.

This study provides, for the first time, specific estimates for excess length of stay, charges, and the risk of death for 18 of 20 AHRQ Patient Safety Indicators. In commenting on the study, AHRQ Director Carolyn M. Clancy, M.D., pointed out that the study has provided us with the first direct evidence that medical injuries pose a real threat to the American public and increase the costs of health care. Hospitals can take information from this study and use it to enhance the efforts they are already undertaking to reduce medical errors and improve patient safety.

Details are in "Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization," by Dr. Zhan and Marlene Miller, M.D., M.Sc., in the October 8, 2003, Journal of the American Medical Association 290, pp. 1868-1874.

Reprints (AHRQ Publication No. 04-R001) are available from the AHRQ Publications Clearinghouse.

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