Study Says Hospital Cost Controls Can Hurt Care

Hospital efforts to streamline operations and reduce costs put patients at risk for preventable mistakes, according to a study published in the May issue of Medical Care, the Boston Herald reports.

For the study, researchers at Brigham and Women's Hospital and Massachusetts General Hospital reviewed 6,841 patient records at four hospitals over 12 months. Two of the hospitals were urban teaching hospitals and the other two were suburban hospitals in two states.

The analysis showed 1,530 adverse events that were not caused by the patient's original condition. Preventable mistakes include medication errors, nerve injuries and infections, among other adverse events (Fargen, Boston Herald, 4/24).

At one hospital, a 0.1% increase in the patient-to-nurse ratio caused a 28% increase in preventable adverse events, according to the study (Bates et al., Medical Care, May 2007).

The other hospitals studied were not as crowded and did not show an increase in adverse events during peak hours, according to the study.

David Bates, senior author of the report and chief of the division of general medicine and primary care at Brigham and Women's, said hospitals' goals of cutting costs and increasing the quality of patient care are "working against each other," adding, "Hospitals are clearly stressed."

Linda Kenney -- director of Medically-Induced Trauma Support Services in Massachusetts, who did not take part in the study -- said, "This is not due to individuals not being caring. It's due to systems that aren't set up to do the best job possible. When you have a nurse who has to take care of 10 patients, instead of six, things are going to be overlooked" (Fargen, Boston Herald, 4/24).