Feature Story

Surgical errors cost nearly $1.5 billion annually

Potentially preventable medical errors that occur during or after surgery may cost employers nearly $1.5 billion a year, according to new estimates by researchers William E. Encinosa, Ph.D., and Fred J. Hellinger, Ph.D., of the Agency for Healthcare Research and Quality (AHRQ). The study found that insurers paid an additional $28,218 (52 percent more) and an additional $19,480 (48 percent more) for surgery patients who experienced acute respiratory failure or post-operative infections, respectively, compared with patients who did not experience either error. The authors also found these additional costs for surgery patients who experienced the following medical errors compared with those who did not:

• Nursing care associated with medical errors, including pressure ulcers and hip fractures—$12,196 (33 percent more).
• Metabolic problems associated with medical errors, including kidney failure or uncontrolled blood sugar—$11,797 (32 percent more).
• Blood clots or other vascular or pulmonary problems associated with medical errors—$7,838 (25 percent more).
• Wound opening associated with medical errors—$1,426 (6 percent more).

The study also found that 1 of every 10 patients who died within 90 days of surgery did so because of a preventable error and that one-third of the deaths occurred after the initial hospital discharge. The study was based on a nationwide sample of more than 161,000 patients age 18 to 64 in employer-based health plans who underwent surgery between 2001 and 2002.

The authors used AHRQ's Patient Safety Indicators to identify medical errors. Drs. Encinosa and Hellinger conclude that studies that focus only on medical errors incurred during the initial hospital stay may underestimate the financial impact of patient safety events by up to 30 percent.

For details, see the "Impact of medical errors on 90-day costs and outcomes: An examination of surgical patients," by Drs. Encinosa and Hellinger in the July 2008 Health Services Research. Reprints (AHRQ Publication No. 08-R079) are available from the AHRQ Publications Clearinghouse.

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