JAMA Study Refutes IOM Report Estimates of Medical Errors
Although a 1999 Institute of Medicine report estimated that medical mistakes in hospitals kill up to 98,000 patients per year, a new study in today's Journal of the American Medical Association puts the number at between 5,000 and 15,000, the AP/Philadelphia Inquirer reports (Webber, AP/Philadelphia Inquirer, 7/25). In the study led by Dr. Rodney Hayward, director of the Veterans Administration Center for Practice Management and Outcomes Research, doctors examined 111 hospital deaths at seven VA hospitals between 1995 and 1996. After examining the patients' medical records, the doctors determined that 22.7% of the deaths could have been prevented if the patients had "received optimal care," and 6% of the deaths were "probably or definitely preventable" -- figures similar to other studies (Hayward/Hofer, JAMA, 7/25). However, in a "closer examination," the researchers discovered that the consulting doctors did not all agree on what constitutes a deadly error. In almost every case where one of the consulting doctors said an error had caused the death, the majority of the reviewers did not share that opinion. In addition, there often was "no good evidence to support the finding" that an error had caused a death, the report found. From the closer examination, researchers determined that with "optimal care" only 0.5% of the patients in the study would have lived at least three months in good health. Hayward said the 5,000-15,000 figure is just an estimate, adding that his study is not meant "to suggest that medical errors are unimportant." He said, "The argument is to be careful about what you implement." The IOM report prompted HHS to recommend ways to reduce medical errors and the nation's hospitals to implement new protections. Hayward said he was "worried" that medical error reports would discourage people from seeking medical treatment. IOM medical error report co-author Dr. Lucian Leape of the Harvard School of Public Health defended his report's findings, adding that Hayward's findings are "based on too small of a sample and [were] derived by way of 'statistical torturing'" (AP/Philadelphia Inquirer, 7/25).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.