Surgery News - September 2008 - (Page 11) SEPTEMBER 2008 • SURGERY NEWS PRACTICE TRENDS Additional Surgery Costs for Patients Resulting From Medical Errors Acute respiratory failure Infections Nursing-sensitive events Metabolic problems Pulmonary and vascular problems Wound problems $1,426 Technical problems $646 $12,196 $11,797 $7,838 $28,218 $19,480 11 Preventable Surgical Errors Cost $1.5 Billion Annually B Y A L I C I A A U LT reventable surgical errors are likely costing insurers more than $1 billion a year, according to a new study by the Agency for Healthcare Research and Quality. The report is a fuller accounting of the true cost of potentially preventable errors than had been previously published, according to the authors, William E. Encinosa, Ph.D., and Fred J. Hellinger, Ph.D., both with AHRQ’s Center for Delivery, Organization, and Markets. They looked at the comprehensive, perepisode cost of medical errors, including payments to hospitals for the initial admission and readmission; and payments for physicians, for outpatient services, and for prescription drugs. All cost data were included for 90 days after surgical admission. The authors drew their analysis from the 2001-2002 MarketScan Commercial Claims and Encounter Database, which covers 5.6 million enrollees in private, employersponsored plans (Health Serv. Res. [doi: 10.1111/j.1475-6773.2008.00882.x]). “Most papers that estimate the cost of medical errors only examine the initial hospitalization in which the medical error occurred,” they wrote. But, they added, “We find that the death rate increases by 50% over 90 days once the patient leaves the hospital.” Postdischarge costs also are often higher than those for the initial admission, they noted. By looking at an entire episode of care over 90 days, the researchers make a strong argument in favor of spending money on quality, Dr. Darrell A. Campbell, an ACS Fellow and professor of surgery at the University of Michigan, Ann Arbor, said in an interview. The case-control study examined 14 potentially preventable adverse medical events, defined by AHRQ as patient safety indicators. A total of 161,004 adult, nonelderly, major operations were analyzed; 2.6% (4,140) of cases had at least one of the 14 preventable events, and 5.6% of those cases had additional errors. Acute respiratory failure was the most common preventable event, which occurred in 0.9% (1,392) of all surgical procedures. That also was the most expensive event, at $106,000 per instance, and patients who had respiratory failure also had the highest death rate, at about 12% over the 90-day period tracked. For all patients who had at least one preventable event, the 90-day death rate was 6%, versus 0.6% for those without a preventable event. The 90-day readmission rate was 15% for patients with an event, versus 5.5% for those without. In all, 23% of patients who had potentially preventable events were readmitted, versus 10% of those without an event. The 90-day cost for an operation that included a potentially preventable event was $66,800, compared with $18,200 for a procedure that did not involve such an event. Lengths of stay were longer, at 22 days for patients with events, versus 5 days for those without. P Note: Based on 2001-2002 data for 161,004 observations from MarketScan Commercial Claims and Encounters Database. Source: Health Services Research The American College of Surgeons and the National Ultrasound Faculty have developed “Ultrasound for Surgeons: The Basic Course” for surgeons and surgical residents on CD-ROM. The objective of the course is to provide the practicing surgeon and surgical resident with a basic core of education and training in ultrasound imaging as a foundation for specific clinical applications. ^ Replaces the basic course offered by the American College of Surgeons. ^ A printable CME certificate is available upon successful completion. ^ CD will install the necessary software (PC or Mac). ^ The learner is offered two attempts to pass a multiple-choice exam with a minimum score of 80% at the completion of the program. ^ Residents must submit a letter from their director/chair to document residency status. ^ Only one user per CD is allowed. Online access is needed to register the CD and to take the exam. ^ ^ ^ ^ $300 for nonmembers $225 for Fellows of the College $125 for residents with letter proving status* $90 for Resident and Associate Society (RAS) members (Additional $16 for shipping and handling of international orders) *Non-RAS residents must supply a letter confirming status as a resident from a program director or administrator and are limited to one CD-ROM. The CD can be purchased online at http://www.acs-resource.org or by calling Customer Service at 312/202-5474. For additional information, contact Olivier Petinaux, MS, tel. 866/475-4696, e-mail elearning@facs.org The American College of Surgeons (ACS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ACS designates this educational activity for a maximum of four AMA PRA Category 1 Credits™ toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity. The American Medical Association has determined that physicians not licensed in the U.S. who participate in this CME activity are also eligible for AMA PRA Category 1 Credits.™ ELSEVIER GLOBAL MEDICAL NEWS Else vier Global Medical Ne ws By extrapolating the results to the entire population of insured nonelderly adults in the United States, the authors report that 11% of 90-day postdischarge deaths and 2% of 90-day readmissions are due to the 14 potentially preventable adverse events, and 2% ($1.5 billion) of all 90-day expenses after surgery. Going forward, it will be possible to collect stronger data on errors because hospitals are now recording whether certain preventable conditions are present on admission, Dr. Campbell said. ■ http://www.acs-resource.org http://www.acs-resource.org
Table of Contents Feed for the Digital Edition of Surgery News - September 2008 Surgery News - September 2008 Contents Appreciation Low Scores News From the College: New Leader Practice Trends: High Price to Pay Surgery News - September 2008 Surgery News - September 2008 - Contents (Page 1) Surgery News - September 2008 - Contents (Page 2) Surgery News - September 2008 - Contents (Page 3) Surgery News - September 2008 - Appreciation (Page 4) Surgery News - September 2008 - Low Scores (Page 5) Surgery News - September 2008 - Low Scores (Page 6) Surgery News - September 2008 - Low Scores (Page 7) Surgery News - September 2008 - News From the College: New Leader (Page 8) Surgery News - September 2008 - News From the College: New Leader (Page 9) Surgery News - September 2008 - News From the College: New Leader (Page 10) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 11) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 12) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 13) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 14) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 15) Surgery News - September 2008 - Practice Trends: High Price to Pay (Page 16)
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