New research shows patients suffered nearly 62,000 medical errors during a single year in Massachusetts, resulting in more than $617 million in related insurance claims.
The Betsy Lehman Center for Patient Safety compiled its latest report after conducting two studies. The first analyzed health insurance claims data. The second study randomly chose 5,000 households in Massachusetts. Nearly 1,000 people responded they had suffered a medical error or someone in their household or a close family member had. The center heard from 253 people in a follow-up survey.
The Betsy Lehman Center was founded following the death of Betsy Lehman in 1994. Lehman, a Boston Globe health columnist, suffered a massive overdose of chemotherapy at the Dana-Farber Cancer Institute in December 1994.
Two months after her death, Dana Farber staff informed Lehman’s family there had been a medication error. This was a rare step and the Boston Globe began investigating patient safety. Today, the Betsy Lehman Center operates as a non-regulatory state agency, reporting on medical errors and leading patient safety initiatives.
From the report:
Report “underestimates” medical errors. The Betsy Lehman Center said its reporting likely underestimates the number of medical errors in Massachusetts. This is because diagnostic and medication errors may not be reliably tracked by analyzing insurance claims.
Emotional toll. Patients and their families suffer for years after medical errors. Nearly 30 percent saw an impact on their physical health for at least one year or more, according to the report. One-third of the respondents were still anxious 3-6 years later. One in 5 were depressed and more than 25 percent were sad or angry.
Avoiding health care. One third of survey respondents said they “sometimes” or “always” avoid medical care in general. Two thirds continue to carry reduced levels of trust during medical care. More than half of the respondents still avoid individual doctors and health care systems, even though 3 to 6 years had passed since the incident.
Medical errors can happen anywhere. Massachusetts has highly rated hospitals, but similar rankings are not available for outpatient and long-term care. Many medical errors happen in outpatient settings. In fact, one in 20 patients suffers a medical error during outpatient care, according to research published by Quality & Safety in 2014.
Medical errors are most common in hospitals (41 percent) and doctor’s offices or clinics (27 percent) and the emergency room (15 percent). Another 17 percent of mistakes happen in other healthcare settings, including pharmacies, dental offices and nursing homes.
Massachusetts “I’m sorry” law. Massachusetts passed the health payment reform act in 2012. The law provides physicians a “cooling off” time to disclose medical errors and apologize to patients and families. Physicians are required to inform patients when there is an “unanticipated outcome with significant medical complication resulting from the provider’s mistake.”
Yet the report shows many doctors are not apologizing. Just 19 percent of those surveyed said they received an apology from a doctor. Most of those – 82 percent – felt they received a sincere apology.
After mistakes, just 25 percent of patients and families were offered support services by medical providers. About 8 percent were offered psychological counseling. Another 13 percent were offered spiritual support from a religious advisor. Another 11 percent were asked if they needed assistance from a social worker.
Most providers are not offering additional financial assistance or compensation. Just 3 percent offered patients and families help paying out-of-pocket medical costs following a medical error. Two percent of patients and families received financial compensation for injuries caused by medical errors.
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A new Medicare report found that U.S. hospital employees are failing to report the majority of medical errors they make or observe.
The report was issued today by the inspector general of the Department of Health and Human Services. In reviewing 293 cases in which patients had been harmed, the inspector general found 40 cases were reported to hospital managers and 28 were investigated by hospitals. Only five cases prompted change.
The inspector general estimated more than 130,000 Medicare beneficiaries experienced one or more adverse events or medical errors in hospitals in one month.
The review defined adverse events as medication errors, hospital-acquired infections,
excessive bleeding linked to blood thinner, severe bedsores and overuse of painkillers. Other adverse events at hospitals may include surgical errors, birth injuries and failure to respond to a hospital alarm.
The review found that many hospital employees were fearful about reporting medical errors after the Institute of Medicine’s 1999 landmark report, which estimated up to 98,000 people die in U.S. hospitals each year from preventable medical errors.
But here, employees often failed to recognize what constitutes patient harm, did not realize patients were harmed or assumed someone else would report it. In some cases, employees thought the mistake was so common it did not require reporting.
In recent years, hospitals have been required to track medical errors and adverse patient events as part of their Medicare contract. At least 27 states, including Massachusetts, have implemented laws for mandated reporting of healthcare errors.
Following the inspector general’s report, Medicare officials plan to develop a list of “reportable events” for hospitals and employees. Hospitals are also being asked to give employees their own instructions.
Click for a New York TImes article about this review.
Click for a review of state reporting laws from the National Conference of State Legislatures.