Adverse events among inpatient admissions hit 25% in 2018
Adverse drug events comprise 39% of the adverse events, making them the most common by far.
Photo: Xavierarnau/Getty Images
Almost 25% of inpatient admissions in 2018 experienced at least one adverse event while 7% experienced a preventable adverse event, according to new data published in the New England Journal of Medicine.
The analysis, which looked at about 2,800 admissions across 11 hospitals, found 978 adverse events, many of them serious, and a small percentage – 1% – that were both serious and preventable.
Such events have been a consistent problem for decades. Researchers pointed to the 1991 Harvard Medical Practice Study, which uncovered similar findings from more than 30 years ago. The HMPS attributed almost 30% of adverse events to provider negligence, though narrower criteria at the time meant pulling from a smaller sample size.
"Three decades after the HMPS drew attention to the issue of healthcare-associated patient harm, in-hospital adverse events continue to be common," the authors wrote.
WHAT'S THE IMPACT?
For the purposes of the analysis, an adverse event was defined as an unintentional physical injury resulting from or exacerbated by medical care. These events require additional monitoring, treatment and oftentimes hospitalization. They can occasionally result in death.
Among samples taken across 11 Massachusetts hospitals spread over three health systems, data showed that adverse drug events made up 39% of these adverse events, making them the most prevalent. Surgical procedures represented about 30% of adverse events, followed by nursing care-associated events (15%) and healthcare-associated infections (11.9%).
Older patients and men saw higher rates of these adverse events, while they happened less frequently in Asian Americans as compared to Black or White patients. Hispanic patients also saw lower rates, as did those who used Medicaid as their primary insurance.
Researchers cautioned that these numbers may be conservative due to the exclusion of events that were present at the time of hospital admission, though the number of events that are considered "adverse" has increased since the days of HMPS.
Potential ways to address the problem, they said, include enhanced surveillance, longitudinal electronic patient records and collaboration across facilities.
THE LARGER TREND
The fall 2022 Leapfrog Hospital Safety Grade results, released in November, showed an overall reduction in never events – adverse events that should have been avoided – as well as progress in stemming healthcare-associated infections.
Measures used in the Hospital Safety Grade have changed over time, but measures that could be reliably tracked over the past decade show a consistent pattern of better performance. For five of the outcome measures that can be tracked, these improvements saved an estimated more than 16,000 lives over the 10-year period, Leapfrog's numbers showed.
The findings from Leapfrog's fall report contrasts with the spring report, which found an overall decline in patient safety measures the report considers "significant," though the spring report did not take a broad look at the past decade, as the new edition has done.
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
