This summer a large study found “statistically significant decreases in the annual rates of in-hospital adverse events” for numerous indicators of patient safety. The study looked at a ten year period from 2010 to 2019 – roughly the first ten years of the Affordable Care Act. While calls for improving patient safety have been made, well, forever, it is possible that some key aspects of the ACA actually helped make these improvements happen. It is likely that mandates in the ACA have led to transparency that benefits patients.
Over a ten-year period since the ACA was passed, rates of in-hospital adverse events for myocardial infarction, heart failure, pneumonia, and major surgical procedures dropped significantly (17%, 17%, 21%, and 22% respectively). There was a similar significant decrease (22%) in adverse events from 2012-2019 for all over conditions. This isn’t just statistically significant – this is a really big deal for loved ones and their families.
By way of some background, the Centers for Medicare and Medicaid (CMS) started in 2010 to report incidence rates for patient safety indicators. Hospitals are required to report specific metrics and incidents to CMS. These include, for example, infection rates, readmission rates, and other healthcare-associated conditions. You may recall that CMS uses a payment penalty to hospitals who fail to meet certain thresholds, or those that chronically underperform. CMS was, in effect, using the carrot of full Medicare reimbursement and the stick of making publicly available the results of hospitals reporting adverse events.
At least one non-profit organization started collecting this publicly available data and created an annual Hospital Safety Grade. This large database is comprehensive and user friendly.
Notably, the COVID-19 pandemic had a detrimental effect on patient safety across nearly every metric. But, the research from this 2010-2019 time period helped inform researchers just to what extent the pandemic affected the trajectory of improving patient safety.
Further research needs to be done, as ever, but this correlation suggests that transparency is benefitting patients in measurable ways.
