12,000 Hospital Deaths In England Every Year Could Have Been Avoided

Date: Jul-18-2012According to a data analysis published online in BMJ Quality and Safety, about 12,000 deaths could be prevented in acute hospitals in England every year. The findings revealed that the majority of deaths were due to poor clinical monitoring and diagnostic errors.

The authors state that even though the number of deaths is still significant, the analysis reveals that these figures are substantially lower compared with previous estimates of between 60,000 to 255,000 cases of serious disability or death that occurred as a direct result of NHS (National Health Service) treatment.

The findings are based on 2009 case record reviews of 1,000 adult patient deaths at 10 randomly selected acute hospitals in the UK that were thoroughly examined by experienced medical professionals with regard to potential acts of omission, which included failure to treat and/or incorrect diagnosis or acts of commission, like incorrect treatment or unintended complications of healthcare.

The medical professionals then judged each individual case by using a scale as to whether any problems they discovered could have been related to the death of that person and therefore could have been prevented, considering the patients' overall health at that time. The scale ranged from 1 to 6, with 1 meaning that the death was 'definitely not preventable' up to 6, standing for 'definitely preventable'. In addition, the team also estimated each patient's life expectancy on admission to determine which groups of patients were most affected.

According to the analysis, a total of 131 patients received inadequate care that contributed to their death. The findings also revealed that patients admitted under surgical specialties were at almost double the risk.

The results showed that 52 patients, i.e. 5.2% of all deaths had a 50% higher chance of survival if they would have received the correct care in hospital. Even though the team discovered that problems occurred during all stages of care, 37 or 44% of problems that could have contributed to prevent the death of that person had happened during care on the ward.

In nearly one in three cases (31%) preventable deaths was linked to poor clinical monitoring, whilst slightly less than 30% of preventable deaths were due to a wrong diagnosis and one in five cases or 21% were due to poor drug or fluid management.

An extrapolation of these 5% preventable deaths on all acute hospital admissions in the UK would translate to 11,859 preventable deaths, which is substantially lower compared with suggestions of earlier estimates. More than half of these deaths, i.e. 60% occurred in frail, elderly individuals who suffered from multiple health problems and whose life expectancy was no longer than one year.

The researchers conclude:

"While the spectre of preventable hospital deaths may prove helpful in raising interest in patient safety and a commitment to improvement, overestimating the size of the problem and the risk to patients may induce unjustified levels of anxiety and fear among the public. In addition, confirmation of the relatively small proportion of deaths that appear to be preventable provides further evidence that overall hospital mortality rates are a poor indicator of quality of care."

The researchers indicate that preventable deaths may not be the most productive method to identify gaps in care quality that can be modified, which can affect patient outcomes.

Written by Petra Rattue

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