Avoidable Death, Injury from Medical Error Varies by Congressional District: Study

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Study from Health Quality Advisors and iVantage Health Analytics rates each Congressional district by the preventable deaths and injuries in its hospitals.

A new report rates each Congressional district by the preventable deaths and injuries its hospitals cause every year and examines whether districts represented by Republicans or Democrats provide better care.

"The Politics of Patient Harm: Medical Error and the Safest Congressional Districts" poses the question of Congressional district safety not in regard to a representative’s political health in an election year, but in relation to the risk to physical health of constituents. In what is believed to the first analysis of its kind, the report found that in each Congressional district ranked “poor” on safety, preventable medical errors cause an average of 553 deaths and 4,148 injuries annually. In districts rated “fair,” the average annual toll was 469 deaths and 3,518 injuries each year, and in “good” districts, it was 385 deaths and 2,888 injuries.

On average, 14 more individuals die and 105 are injured every month in hospitals located in districts rated “poor” on safety than in those rated “good.” Even in “good” districts, however, at least one individual dies unnecessarily every day; another eight are harmed.

“It’s time to make patient safety personal to Congress,” said lead author Michael L. Millenson, president of Health Quality Advisors, LLC. “These are local hospitals causing preventable harm to constituents.”

The nation’s top-ranked district for patient safety was represented by Virginia Foxx (R-NC). The bottom-ranked one was represented by Gregory Meeks (D-NY). Of 434 House districts that could be rated, 59 had hospitals that were less safe than the norm and 114 districts were safer. Collectively, the 10 safest districts were almost twice as safe as the 10 least safe ones.

The report found that overall patient safety was about the same in districts represented by Republicans and Democrats. Hospitals were also equally safe (or unsafe) in a district represented by a powerful political leader and a little-known backbencher or by a Congressman whose seat was safe versus one whose hold on his seat was tenuous.

“When it comes to patient safety, politics truly doesn’t count,” wrote Millenson and co-author John R. Morrow, a founder of iVantage Health Analytics, Inc. “Unfortunately, that means Americans in every state still confront an unacceptably high risk of preventable injury or death from medical care.”

The report evaluated 4,558 general, acute-care hospitals using 20 recognized patient safety measures, including seven measures of infection control or prevention, to produce an overall Congressional district score. It did not rank individual hospitals.

The authors also estimated the economic impact of harm. In districts ranked “poor” on patient safety, the collective direct and indirect costs totaled $7.7 billion; in “fair” districts, $6.5 billion; and in “good” districts, $5.3 billion.

Recent studies suggest at least 200,000 Americans and possibly more than 400,000 die each year in hospitals from preventable medical error, making it the nation’s third-highest cause of death.

“This report reminds us that elected officials have the power to help stop medical errors from which people in their own districts are dying every day,” said Helen Haskell, president of Mothers Against Medical Error and a board member of the National Patient Safety Foundation. “At a minimum, it’s time for our representatives to come together in a bipartisan manner on behalf of patients.”

The report criticizes the slow pace of safety improvement and provides a series of recommendations. Among them are a call for Congress to require the release of more useful, timely, and reliable safety information, opening the way for a new consumerism. The report notes that if all members of the U.S. House were hospitalized, it’s likely 30 of them would be harmed, some fatally, by their care. It concludes: “The life a Congressman saves could well be his own.”

The report and data tables, including a listing of each Congressional district’s patient safety rating, can be found at http://www.safedistricts.com.

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Michael L. Millenson, president of Highland Park, Illinois-based Health Quality Advisors, LLC, is a nationally recognized expert on making American health care better, safer, and more patient-centered. He is the author of the critically acclaimed book, Demanding Medical Excellence: Doctors and Accountability in the Information Age, and he holds an adjunct appointment as the Mervin Shalowitz, M.D., Visiting Scholar at Northwestern University’s Kellogg School of Management. See: http://www.millenson.com.

John R. Morrow is a co-founder and director of Portland, Maine-based iVantage Health Analytics, Inc. and a pioneer in the health care business intelligence sector. iVantage is a leading advisory and business analytic services company applying Accelerated Healthcare Transformation™ and the VantagePoints™ platform to drive sustained, evidence-based results. See: http://www.ivantagehealth.com.

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