Medicare's new chief called for more steps to improve patient safety in the wake of a government report that said one in seven hospitalized Medicare patients is harmed during their stay. About 1.5 percent of those patients, or 15,000 people a month, suffered a complication that contributed to their death, the inspector general for the Department of Health and Human Services said.
"We have to do better," Dr. Donald Berwick, a well-known quality-care specialist, told reporters. His agency unveiled a new Medicare innovation center designed to develop and test ways to improve quality of care and lower health care costs for everyone, not just Medicare recipients. The program is one of several established by the new health care law to help Medicare spur improvements in patient safety.
Initial projects focus on helping primary care physicians better coordinate care across multiple health providers, countering today's fragmented care that too often leaves one doctor not knowing what tests or treatments someone received or missed elsewhere. One project will work with doctors in eight states — Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota. A second will offer similar integrated care in hundreds of low-income health clinics around the country.
Better primary care can reduce the chances that people end up in the hospital, Berwick said. That hospitals are dangerous places, rife with infection and opportunities for errors, isn't new. The Institute of Medicine a decade ago warned that up to 98,000 people a year die from medical mistakes alone. The new HHS report analyzed the records of 780 Medicare patients hospitalized in October 2008 to examine mistakes and unavoidable consequences of treatment, such as previously unknown drug allergies or medication side effects. During that month, 134,000 Medicare patients suffered at least one adverse event while hospitalized, 44 percent of which were preventable, the report concluded.
Late 2008 was when Medicare launched a major program to reduce hospital-caused complications by refusing to pay hospitals for extra treatment required for patients who suffered any of a list of preventable harms. The new report may provide a baseline to measure those efforts.