AHRQ Report Finds Drop in Hospital-Acquired Conditions
Focused efforts to reduce hospital-acquired harm resulted in 50,000 fewer deaths and $12 billion in savings from 2010 to 2013, according to a report released by the Agency for Healthcare Research and Quality on Tuesday, Modern Healthcare reports (Rice, Modern Healthcare, 12/2).
The report is based on an analysis of tens of thousands of medical records (Begley, Reuters, 12/2). It updates findings HHS released earlier this year (Norman, Politico Pro, 12/2). In that report, HHS found a 9% decrease in preventable adverse events in hospitals from 2010 to 2012 (California Healthline, 5/8).
Report Reveals Major Drop in HACs From 2010 to 2013
Overall, the report found that hospital patients experienced 1.3 million fewer hospital-acquired conditions -- such as surgical infections, drug reactions and other preventable events -- during the three-year period from 2010 to 2013. As a result, there were 17% fewer HACs in 2013 than in 2010 (Modern Healthcare, 12/2).
The report highlighted major improvements from 2012 to 2013, when the HAC rate decreased by 9% (Reuters, 12/2). In 2013 alone, preliminary data suggest that there were about 800,000 fewer HACs in hospitals compared with the 2010 baseline, saving about $8 billion and preventing nearly 35,000 deaths (HHS release, 12/2).
CMS Deputy Administrator Patrick Conway called the progress an "unprecedented decline in patient harm in this country" (Reuters, 12/2). Officials attributed some of the reductions to Affordable Care Act provisions, such as penalties for HACs that were implemented this year and HHS' Partnership for Patients initiative (Politico Pro, 12/2).
HAC 'Rate Is Still Too High'
However, the HAC "rate is still too high," according to the report.
Despite the recent gains, nearly 10% of patients will experience one or more HAC during their stay. The Partnership for Patients effort aimed to reduce HACs by 40% by the end of 2013, which would have required avoiding 1.8 million HACs from 2010 to 2013. The program has extended the deadline for that goal until the end of 2014.
Some experts expressed concern that hospitals do not know how to improve on all measures of HACs. Don Goldmann, the chief medical and science officer at the Institute for Healthcare Improvement, noted that the 49% reduction in central line-associated bloodstream infections is not surprising in light of the myriad checklists, best practices and information sharing that have created "urgency and focus" around the issue. But for other kinds of patient harm, "it's just not all lined up quite as well," he said.
Meanwhile, some experts argue that the Partnership for Patients failed to establish effective measures and apply them across its 26 Hospital Engagement Networks, which include more than 3,700 hospitals.
Moreover, Peter Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, said some improvement can be linked to better record keeping, rather than actual improvements for patients. "Is this in the best interest of patients or the public? I do not think so," he said.
Rich Umbdenstock, president of the American Hospital Association, acknowledged the need for more collaborations and work on HACs. "The more public and private alignment there is, the better the evidence will be and the more sustainable the focus," he said (Modern Healthcare, 12/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.