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Adverse events in Medicare patients

December 2010

Published in the December 2010 issue of Today’s Hospitalist

One in seven Medicare inpatients harmed

A NEW STUDY FROM THE OFFICE OF THE INSPECTOR GENERAL finds that 13.5% of Medicare beneficiaries experience an adverse event while they’re hospitalized, while another 13.5% experience some other form of temporary harm in the hospital, such as hypoglycemia.

The report, which was issued last month, looked at a random sample of Medicare patients hospitalized during October 2008. The analysis indicates that 44% of adverse and temporary-harm events are preventable. The price tag for adverse events for Medicare per year, the report said, is about $4.4 billion. Only 1% of the adverse events found consisted of “never events,” such as wrong-site surgery. Infections were cited as a major problem, as were adverse events related to medications.

The report advises the Centers for Medicare and Medicaid Services (CMS) and the AHRQ to “broaden patient safety efforts,” which should include setting research priorities, prevention strategies and adverse-event reporting guidelines. The report also recommended that the CMS devise financial incentives for hospitals to help reduce event rates.

In-hospital AEDs linked to lower survival rates

WHILE HOSPITALS HAVE PURCHASED more than 50,000 automated external defibrillators (AEDs) to use on inpatients who arrest, a new study finds that the use of AEDs in hospitals is associated with lower survival rates.

The study, which was posted online last month by the Journal of the American Medical Association, found that 18% of patients who arrested in the hospital survived to discharge. However, the survival rate was 16.3% for shocked patients vs. 19.3% for those not shocked. The cohort study looked at more than 11,600 patients who arrested on the wards in more than 200 U.S. hospitals between Jan. 1, 2000, and Aug, 26, 2008.

The authors write that the majority of in-hospital arrests “more than four out of five “are due to nonshockable conditions such as asystole and pulseless electrical activity. (Many more patients with out-of-hospital arrests have shockable conditions such as ventricular fibrillation or pulseless ventricular tachycardia, researchers said.) The authors conclude that when responding to an arrest, providers make the mistake of stopping chest compressions, which can be effective, to administer an AED.

How much more do surgeons make?

A NEW STUDY FINDS that specialists are paid as much as 52% more than primary care and generalist physicians, even though generalists see more patients.

Researchers writing in the Oct. 25 issue of Archives of Internal Medicine looked at 2004-05 compensation data from more than 6,000 doctors in 60 communities. Unlike previous analyses, the authors assessed hourly wages based on compensation and reported hours worked per day.

They found that generalists, including pediatricians, earned $60.48 per hour; internal medicine and pediatric specialists earned $84.85 per hour; other specialties, including emergency medicine and dermatology, earned $88.08 per hour; and surgeons earned $92.10 per hour. The report also found that women physicians earn $9 per hour less than their male colleagues across all specialty groups.

New film festival seeks entries on infection control

THE ASSOCIATION FOR PROFESSIONALS in Infection Control and Epidemiology (APIC) is inviting budding medical film-makers to submit documentaries, short films and videos for the APIC Film Festival, which will be held June 27-29, 2011.

Films should illustrate the themes of infection control, prevention and education, and they should be no longer than 10 minutes. Applicants must upload their film or films (multiple submissions are allowed) to YouTube no later than Dec. 31 to be eligible. Applicants must also complete an online registration form.

According to the entry rules, any video or film that’s not in English must come with English subtitles. In addition, entries may not feature any commercial products or political candidates or points of view.