Approximately one of every seventeen patients is exposed to preventable injuries during medical care. That figure is half the overall rate of injuries patients suffered across multiple areas of medicine. Not surprisingly, the rates of harm and preventable injuries are significantly higher in invasive procedures and intensive care. Whether these statistics are surprising to you depends on your perspective of health care.
The calculations come from a recent meta-analysis of sixty-six studies across the fields of general hospital care, intensive care, emergency medicine, obstetrics, primary care, pediatric care and geriatric care. The results reflect a sample of 337,025 patients; of whom 28,150 suffered harmful incidents (12%). Of these, 15,418 (6%) were considered preventable at the times of their respective studies. “Patient harm” is defined as unanticipated unforeseen accidents that are the direct result of care dispensed rather than underlying disease. For this study the harm, broadly, is preventable if it occurs as a result of an identifiable modifiable cause and its future recurrence can be avoided by reasonable adaptation to a process, or adherence to guidelines.
The highest rates of preventable harm were in intensive care (in 18% of patients) and surgery (13%); the lowest was in obstetrics (2%). The most common types of patient harm were medication related, therapeutic management, and invasive and medical procedures. The researchers classified the reported severity of the preventable harm into mild, moderate, and severe. Half of the preventable harm was considered mild; some 12% was considered severe. The three levels were as reported by the original reporting studies, so further specificity as to what that means for each field of medicine, for purposes of the study and this post, is unavailable.
What does this mean for you and me? These preventable injuries cost medical providers money for things such as extended hospital stays; costs that are written off or frequently absorbed by insurance premiums. These costs amount to billions of dollars in unnecessary expense. Further, preventable harm exposes patients and families to unnecessary heartbreak. Finally, these preventable injuries expose the providers to malpractice claims. This last bit falls squarely into our practice area, as we represent victims and families of victims of preventable medical injuries. Keep in mind though that not all preventable injuries are necessary the result of medical negligence.
The study is somewhat prospective looking in that it recognizes that quality assurance programs have a net positive effect on the number of preventable patient harm incidents, and promote further fine tuning of these programs. Interestingly, the researchers found that the rate of preventable harm, as a proportion of patient harm, did not vary over the nineteen year timeframe covered by the studies. Further research into the causes of these harms is warranted, and the study invites further efforts to target the problem areas.
Read the full article [here](https://www.bmj.com/content/bmj/366/bmj.l4185.full.pdf).
