September 2008

Cost of medical errors underestimated

Although the cost of medical errors is shockingly high, the totals may actually be underestimated by as much as 30 percent.

That was the conclusion of a research study performed by William Encinosa, Ph.D., a senior economist at the Center for Delivery, Organization and Markets, of the Agency for Healthcare Research and Quality. He and his colleagues followed insurance claims for 5.6 million enrollees from 2001 to 2002 and noted that the effects of medical errors continue long after the patient leaves the hospital. The results of their study appear in the online journal Health Services Research.

The review suggests that current statistics on medical mistakes might not be comprehensive because they do not factor in all inpatient costs or include readmissions and patient care for the 90 days following surgery.

According to a 1998 report by the Institute of Medicine, an estimated 44,000 to 98,000 Americans die because of medical mistakes each year, with an associated cost of $17 billion to $29 billion.

"Most efforts to measure such costs stop at patient discharge and some symptoms don't happen the same afternoon," said Arthur Levin, director of the Center for Medical Consumers, a non-profit advocacy group. "If a patient stays in the hospital for 27 days, you know when a mistake has been made, but you may not know it if he is discharged and readmitted to another hospital."

If patients use a variety of insurance options to provide coverage, the overall cost might not include such follow-up care.

"You have to follow patients because the reality is that it costs more than most people realize," said Levin, who believes that centralized data could help provide a clearer picture.

The study also revealed the shocking fact that one of every 10 patients who died within 90 days of surgery did so because of a preventable error and that one-third of the deaths occurred after the initial hospital discharge.

SOURCE: "The impact of medical errors on 90-day costs and outcomes: an examination of surgical patients," Encinosa WE, Hellinger FJ. Health Services Research online, 2008.