Medical error studies that focus only on inpatient stays and do not take into account hospital readmissions and other patient care may underestimate costs by up to 30%, according to an analysis of millions of health insurance claims.
William E. Encinosa, Ph.D., and Fred J. Hellinger, Ph.D., researchers at the Agency for Healthcare Research and Quality, examined a database of 5.6 million insurance claims for 14 potentially preventable adverse medical errors defined by the agency's Patient Safety Indicators (PSIs).
PSIs included technical problems, infections, pulmonary and vascular problems, acute respiratory failure, metabolic problems, wound problems, and nursing-sensitive events such as postoperative hip fracture and decubitus ulcer.
“Many hospitals are struggling to survive financially,” Dr. Encinosa said in a statement. “The point of our paper is that the cost savings from reducing medical errors are much larger than previously thought.”
A total of 2.6% of the 161,004 claims for major surgery in an adult included at least one of the 14 potentially preventable adverse medical errors; almost 6% of those claims had more than one error (Health Services Research 2008 July 25 [doi:10.1111/j.1475-6773.2008.00882.x]).
Total 90-day cost for surgery claims with one or more errors was $66,879 on average, compared with $18,284 for surgery claims without an error. In addition, surgeries with one or more errors averaged 21.5 inpatient days, with 5.3 of those days occurring on readmission, the researchers found.
In contrast, surgeries without an error averaged 5.1 inpatient days, with just 1 day of readmission.
Errors associated with the postoperative acute respiratory failure PSI were the most expensive of the seven patient-safety event classes, costing an average of $106,370 over the 90-day period, along with the highest 90-day death rate (12%), according to the researchers.
Readmission costs for the postoperative acute respiratory failure PSI averaged $12,274.