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Physician’s group dismisses HealthGrades’ findings as flawed

Patient Safety Monitor Alert, August 13, 2004

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The American Medical Association (AMA) is discounting a controversial study by the Colorado-based HealthGrades, which found that up to 195,000 patients die each year due to preventable medical errors.

The study, released July 27, examines 37 million hospitalizations of Medicare beneficiaries between 2000 and 2002, and finds that approximately 1.14 million patient safety incidents (PSI) occurred.

Commonly occurring PSIs included failures to diagnose or treat in time, decubitus ulcers, and post-operative sepsis. These three patient safety incidents accounted for almost 60% of all PSIs, according to the HealthGrades report.

The study's most controversial finding pertains to patient deaths due to medical errors. HealthGrades estimates that 195,000 patients die each year from preventable errors--nearly double the number estimated by the Institute of Medicine (IOM) in its groundbreaking 1999 report, To Err is Human: Building a Safer Health System.

The HealthGrades study also found that:

>> Teaching hospitals and larger hospitals (>200 beds) had slightly higher PSI rates per 1,000 than non-teaching hospitals

>> PSIs were more prevalent among medical admissions compared to surgical admissions

>>Hospitals with the lowest PSI incident rates had five fewer deaths per 1,000 hospitalizations compared with hospitals with higher PSI rates

The AMA disputes the accuracy of the HealthGrades study, as well as the accuracy of the IOM estimate.

"Their methodology...relies on claims data that have inherent limitations, including not being able to explain complex situations or make cause-and-effect connections," says Donald J. Palmisano, MD, AMA's past president.

The HealthGrades study applied the mortality and economic impact models used in a research study published in the Journal of the American Medical Association (JAMA) in October of 2003.

However, it will not be published in a scientific journal, however, which would have forced HealthGrades' research to undergo independent criticism.

Samantha Collier, MD, Health Grades' vice president of medical affairs, says her company chose to self-publish the study to disseminate the information to the public faster. The release also was timed to coincide with HealthGrades' announcement of its Distinguished Hospital Award for Patient Safety (see story below).

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