Medical error in hospitals is the third leading cause of death in the U.S.
kurzweilai.net
kurzweilai.net
For example, when my grandmother fell ill, my family spent a lot of time visiting her. My mother, in particular, spent many days and nights there, and her biggest complaint was the complete lack of communication between shifts.
Every few hours, someone new would come into the room, read my grandmother's charts, wake my grandmother up, and ultimately misinterpret several important details. Thankfully my mother was often there to correct them and fill them in on what previous nurses/doctors had already done, but the net result was that my grandmother barely got any rest (being constantly woken for no apparent reason) and, had my mother not been there, a nurse or doctor could easily have made a critical mistake when continuing her treatment.
Another example, still the same grandmother. Even though her original condition improved (after having been rushed to a different hospital), she ended up going home with an entirely new infection which resulted in several more weeks of sickness and eventual recovery. The infection (C. Diff) is one of the leading Hospital-acquired infections and is in many cases totally preventable. It's hard to believe how many people die each year due to infections they pick up in hospitals.
Existing electronic medical records systems are at their best for long-term documentation, and fall short on keeping care providers abreast of ever-changing plans across shift transitions. Pagers and phones, which doctors and nurses use instead for real-time communication, fare even worse. The information is simply invisible to the next person who takes over.
We've had terrific, sustained adoption where Care Thread's system is deployed, and are working to measure the effect on patient outcomes. Some study results are pending (from Partners / Brigham & Women's Hospital in Boston, where researchers put iPads in the hands of patients and used our mobile messaging system to help keep care providers aligned with each other and with patients).
Hmm seems weird and easily addressable to me, I had to spend some time in a hospital in Paris (France) and the staff had a meeting between every shift to discuss how patients were going. To the point that people complained they weren't available at that time... But yeah no experience with US hospitals so YMMV.
That's quite broad
I struggle to see how there are any deaths inside a hospital that don't fall into this category. E.g. a cancer patient on chemo therapy who doesn't make it would seem to qualify.
Realistically I assume this means that they count whatever they want as medical error, with no good rules.
"Are medical errors really the third most common cause of death in the U.S.?"
https://www.sciencebasedmedicine.org/are-medical-errors-real...
Simply put, the headline of the article kindly submitted here surely exaggerates the actual problem. What's undoubtedly a problem is that we don't yet have good data-gathering about when patients die unavoidably and when they die when they could have been saved by standard-of-care medical treatment.
The first paragraph may not be so random in the blog's context, I expect a blog called Science Based Medicine would spend a lot of time doing battle with alternative medicine adherents, but it detracts from this specific article which does a good job deflating this medical errors headline.
... death certificates could contain an extra field asking whether a preventable complication stemming from the patient’s medical care contributed to the death.
How could they do this and, at the same time, shield themselves from lawsuits which use that "extra field" as evidence against them?
Compare with aviation industry, where considerable effort was made to treat accidents as systemic problems and a) making sure individuals won't get immediately blamed for stuff that's not really their fault, and b) that everyone can learn as much as possible from every mistake made so that they don't happen again.
Why is that a desirable goal?
Medicine needs some sort of non-punitive external investigative agency. With the scope so much larger than aviation and death often being a normal outcome, how to structure such an agency would be challenging, but I still think it’s the only way to really address the problem. The same applies for law enforcement and the use of deadly force. While many of the people involved have the best intentions, the pressures of the organization put undue bias on any internal investigation.
It looks like an agency along these lines may have been formed [1], but the ‘At the invitation of healthcare providers’ isn’t good enough. A quick google search found others pushing along these lines [3], and it’s interesting that they are talking about error being the ‘third leading cause of death’ in 2014.
While critics point out that the study may have an overly broad definition of error, it still seems that there is an issue here from anecdotal experience, and that error shouldn’t even be in the top 10.
[1] http://www.prnewswire.com/news-releases/pso-services-group-l... [2] http://www.ntsb.gov/Pages/default.aspx [3] http://safepatientproject.org/press_release/patient-safety-a...
Speaking as a swede I am fed up with seeing how the government undermines public health care at every turn and promoting privatized health care. Health care workers aren't stupid, they're mass migrating from public to private sector. Leaving the public sector in very bad shape with no backup from the government to keep it running.
If you like me believe that your health should not be measured by your wealth then it's down right disgusting.
I have a drug allergy, and one other simple condition that both preclude certain medications being prescribed to me. These conditions do not change over time, and have been in my medical history for 20+ years and yet multiple providers have prescribed medication I can't take to me. I cross check all new prescriptions myself as a matter of course now.
when I was really young I jammed my finger. went to the hospital to get it checked. they were putting a wrist splint on me. I asked how that helped my finger. he quickly took it off.
If I was older I would have just tapped it up.
The US had the highest overall survival rate (73.8%). Countries with government-run medical care, like UK and Denmark, had the lowest: 51-52.8%.
The difference is especially dramatic for prostate cancer, where the US has a 92% survival rate, Australia and Canada were at 77-85% [1], and Denmark was at 38%.
http://www.ncbi.nlm.nih.gov/pubmed/18639491
(Australia and Canada = roughly, countries where hospitals are run privately but the government pays for more than half of all medical care.)
It's not debatable that the U.S. performs relatively poorly by those measures.
> I don't really think there's debate that the US gives the best medical care if money is no object
I've heard people repeat that a lot, but I've never seen evidence of it one way or the other.
In the absence of me showing you the evidence, what is your honest estimate of the probability that it's true?
I have no reason to think that U.S. healthcare, at the high end, is generally superior to that of other rich countries. My guess is that it depends on the field (some do better in, e.g., oncology and others do better in, e.g., brain surgery); that it might vary by hospital or by doctor more than it varies by country; and that results could depend more on operational issues, such as quality control, than on technology or doctor training.
Do you disagree, and if so what would your country/numbers be?
This isn't an argument that has to take place in the hypothetical. When King Abdullah (Saudi Arabia) had to get open heart surgery, he booked it in the US[0]. This is not an isolated case, just the most famous one. I have a lot of personal stories about this, but I'll just leave it at this.
Medical tourism actually runs in both directions. In the US, people often go to other countries for cheap, routine surgeries. Many Middle Eastern countries, on the other hand, are forming partnerships with US hospitals to bring their (American) doctors to the Middle East for effective 'tours of duty', as their solution to equalizing access to health care. (The very wealthy people living in the Gulf already come to the US for their planned treatments, but the middle class[1] can't quite afford it).
If you talk to the most prestigious physicians and surgeons[2] at the top hospitals in the US (like the very, very top physicians at Mass General or NewYork-Presbyterian), you'll find that a sizeable number of their patients are foreigners - often living in the Middle East.
There is some medical tourism from the Gulf to Europe, but it's nowhere near as widespread, and the general impression in the Gulf is that the US is the pinnacle of care quality, which is why they're chasing US practitioners and practice groups so aggressively.
[0] http://pagesix.com/2010/11/30/saudi-king-takes-up-the-entire...
[1] Yes, contrary to popular belief, there is a sizeable middle class in the Gulf.
Aramco - the world's most valuable company - is leaning on Johns Hopkins to staff and run its entire healthcare system. They're not even the only one forming these partnerships with US hospitals and research university - just the most recognizable mame. That's more than just 'ancedotal'.
OP's question was 'which hospital would a wealthy informed person choose'? I'm pointing out that we don't need to speculate, because we already know which one was chosen by the wealthiest company in the world, (owned wholly by the fourth wealthiest country in the world[0]).
[0] The country with the second-largest sovereign wealth fund, by the way, is the UAE, which is also forming the same partnerships (Cleveland Clinic).
The US has a giant population with first-world levels of funding from the government - it's fairly likely that care quality is simply the intersection of population and experience. But you pay more from the government per person, and get less. Your system and outcomes should be so much better and you all should be angry about that. It's just at some level of size and overall budget, you get a lot despite being inefficient.
While I agree that this is the case, the people who are willing to travel for medical care are likely not traveling for routine cases; they are going to see specialists for complex cases. The quality of care varies substantially across the US, and I do think the top tier facilities in the US are some of the best (if not the best) in the world. That says nothing about the average level of care across the country however, and it is typically difficult to get access to these premiere hospitals unless you know someone with connections in medicine or have money.
I wasn't arguing otherwise.
There's a number of individual places in the US and Europe (and possibly some elsewhere) that attract the rich from all over the world, based on reputation as providing the best care for particular conditions. But the US as a whole does not provide the best overall quality of healthcare (outcomes are about average for the developed world) even before considering overall cost, and has overall cost (whether looked at per GDP or per capita) much higher than the rest of the developed world (per GDP, government spending on healthcare in the US is at a fairly typical level for a developed world country where the vast majority of all health spending is by the government, and private spending on healthcare in the US exceeds government spending.)
The inefficiency and wastefulness of US healthcare compared to the rest of the developed world -- most of which have considerably more government involvement in and control of healthcare -- is quite notable.
Otherwise Italy could claim they are building the best cars in the world by having Ferrari and Lamborghini.
In the aggregate and over time, "mistake" is definitely a more desirable cause of death than "we did not know how to fix him," or "we could not afford the machine," or "we did not have enough of the right pills."
Yes, absolutely. I do think my point holds, though–it is not axiomatic that it is indicative of bad care that medical mistakes are rising as a proportional cause of mortality.