Using medical data collected over an eight-year period, patient safety experts at Johns Hopkins have calculated that medical errors are now the third leading cause of death in the US. At more than 250,000 deaths per year attributed to medical mistakes, this number exceeds the Center for Disease Control and Prevention’s (CDC) third most common cause of death – respiratory disease – which is responsible for almost 150,000 deaths each year.
According to the researchers, the CDC’s data does not reflect medical errors, which are often not listed on the death certificate. The authors of the paper – which was published in The BMJ – are urging regulators to update the system used to classify cause of death on these documents.
“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” said Dr. Martin Makary, professor of surgery at the Johns Hopkins University School of Medicine and an authority on health reform. “The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used.”
According to Makary, the US has been using a form based upon the International Classification of Diseases (ICD) billing codes since 1949, to record a person’s cause of death. “At that time, it was under-recognized that diagnostic errors, medical mistakes and the absence of safety nets could result in someone’s death, and because of that, medical errors were unintentionally excluded from national health statistics,” said Makary.
For the past 67 years, national statistics on mortality have been collected based on these billing codes, which lack a mechanism to track cases of death due to medical errors. The researchers completed a meta-analysis of four previous studies which analyzed medical death rate data collected between 2000 and 2008 to better understand how prevalent medical mistakes are.
The researchers extrapolated the results based on the hospital admission rates from 2013. Of a total 35,416,020 hospitalizations that year, the researchers estimate that 251,454 deaths were due to mistakes in treatments. This figure means that 9.5 percent of all deaths in the US each year can be attributed to medical error.
According to data provided by the CDC, in 2013, heart disease was the leading cause of death at 611,105 individuals, with 584,881 patients dying from cancer. The CDC reported the third leading cause of death as respiratory disease, at 149,205 deaths in 2013.
“Top-ranked causes of death as reported by the CDC inform our country’s research funding and public health priorities,” said Makary. “Right now, cancer and heart disease get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.”
The researchers are quick to point out that medical errors are not always the result of poor medical practices, and doctors should not be punished as a result of reporting these errors. Many errors are symptomatic of more systemic problems in healthcare, including complicated insurance networks, variation in physician practice and uncoordinated care.
“Unwarranted variation is endemic in health care. Developing consensus protocols that streamline the delivery of medicine and reduce variability can improve quality and lower costs in health care,” said Makary. “More research on preventing medical errors from occurring is needed to address the problem.”