Given the unbearable costs hospital errors exact on our nation’s sick and injured population every year, it’s sometimes hard to muster optimism. However, a December 2014 report published by the Department of Health and Human Services suggests that medical workers and hospital safety experts may finally be winning the battle – or at least turning the tide.
- The report said that “hospital acquired conditions” (e.g. staph infections caught in a hospital ER) declined over a three year period by 17 percent.
- Medical errors, meanwhile, declined in practically every category.
- IV blood infections, for instance, declined by almost 50 percent.
- Bedsore ulcers — a plague that visits bedridden patients who are not moved frequently enough — declined by 20 percent.
- Pharmaceutical errors also declined by nearly 20 percent.
The timeframe of the report covers 2010 to 2013.
In 1999, the Institute of Medicine found that such errors killed approximately 98,000 people a year in the United States. Later analysis determined that number could be much higher.
Some analysts credit the decrease in errors to the Affordable Care Act (a.k.a. “Obamacare”), which incentivizes hospitals through the “Partnership for Patients” program. This policy has been associated with a reduction in re-admissions (by 18 percent as of early 2014). A pilot program run at Mount Sinai Hospital in New York City found that a similar incentive system led to a drastic cut in re-admissions by over 40 percent.
However, an analysis published in 2012 in the New England Journal of Medicine suggested that government incentives do not necessarily correlate with decline in certain hospital infections.
Hopefully, researchers will analyze this progress more carefully and help us uncover how to make hospitals safer and less error-prone.
Few political issues have been distorted more than the concept of “medical malpractice reform.”
If you ask the average citizen what the consequences would be of raising medical malpractice damage caps, he or she would probably tell you the following:
Raising caps would threaten doctors and force them to practice “defensive medicine.”
It would also lead to spikes in insurance rates and put money into the pockets of lawyers at the expense of the citizenry.
But many respected studies and independent journalistic reports have shown, time and time again, that these fears are totally unfounded. They’re myths. But the insurance industry benefits from promulgating these ideas about medical malpractice reform.
Some voters, safety advocates and politicians (including California’s popular Senator, Barbara Boxer) believe that enough is enough. Golden State voters recently had a chance to vote on Proposition 46, a proposal that would have lifted a cap on medical malpractice damages. For almost four decades, that cap has stagnated at $250,000 without increasing or keeping apace with inflation. Voters ultimately defeated Proposition 46 on the ballot, thanks in part to a multi-million dollar “No on 46” campaign financed by insurance industry interests.
The measure would have also mandated drug and alcohol testing for doctors and forced physicians to refer to a statewide database before prescribing painkillers to their patients.
Bob Pack, who lost his two children (ages 7 and 10) after a nanny high on prescription medications ran them over in 2003, put the situation plainly: “insurance industry profits trumped patient safety.”
But the battle over Proposition 46 at least suggests that the timbre of the national debate has changed. Insurance companies are now on the defensive, and the myths about medical malpractice reform are slowly but surely fading in the light of objective media inquiry.
Most drug advertisements today include a lot of superficial information touting the benefits of medications, including statistics that can make treatments look fantastic and benign. While the statistics these drug makers cite may be accurate, they’re almost always only telling part of the story.
One of the numbers used in assessing the effectiveness of a drug is the “number needed to treat,” or NNT. As a consumer, knowing the NNT can help you make important decisions about whether or not to take a medication. Yet rarely – if ever – is the NNT included in drug ads.
So what is the number needed to treat? It’s the number of patients that would need to be treated in order to achieve the desirable effect or outcome in one patient. For instance, suppose you have a drug that’s intended to prevent stroke. You conduct studies and determine the number needed to treat is 10. What does that mean? It means you would have to treat 10 people with that drug in order to prevent a stroke in one person.
The number needed to treat is a simple way to estimate the potential benefit to be expected from a drug or course of treatment, and it can be an especially helpful marker with respect to comparing one treatment or drug to another.
As noted, the number needed to treat is very rarely included in drug advertising, especially if that number. After all, if the NNT for a new cholesterol drug is 80, that means essentially you’d have a one in 80 chance of having a successful outcome as a result of the medication. Depending on the potential side effects caused by the drug and other factors, you may decide that the benefits and risks just don’t add up.
The NNT can also play an important role in determining negligence of a drug manufacturer whose drug caused significant injury or death.
Turn on the television at just about any time of the day or night, and chances are pretty good that within the first 30 minutes, you will see a commercial promoting a drug. That’s because pharmaceuticals are big business, and the pharmaceutical companies know the best way to make money is to make sure consumers know what their drugs can do.
There’s nothing wrong with advertising in general; but problems can arise when the claims a company makes distort the truth without actually being out-and-out lies. Statistics are often used to skew messages in advertising and elsewhere. And while that practice can be misleading, when it comes to claims regarding medications, this practice can be downright dangerous.
Most drug commercials talk about risk in terms of how well their medications work to prevent whatever ailments they’re intended to treat. But drug makers usually talk about relative risks, often completely leaving out the absolute risks determined by clinical studies.
Absolute risk is your overall risk of developing a disease or condition over time as compared to everyone else. We all have absolute risks when it comes to developing common diseases like heart disease. We can say one out of 10 people will develop X disease in his or her lifetime, which is meaningful when it comes time to determine whether we want to have treatment or not.
Relative risk, on the other hand, compares the risks between two specific groups, often producing results and percentages that are skewed. That makes it difficult to make educated decisions about whether or not to take a medication, for instance, and it can also misstate the actual – or absolute – risks associated with taking a drug.
Understanding absolute and relative risks is also vitally important in legal cases determining negligence of drug manufacturers, and it’s one of the primary reasons why having a skilled attorney is critical in any negligence or medical malpractice case.