Medicare patients continue to experience harm during hospital stays, even after a decade of intensive efforts to decrease provider-caused adverse events, according to a report from the HHS Office of Inspector General (OIG).
Among the roughly 1 million Medicare patients who were discharged from hospitals in October 2018, a total of 258,323 experienced an adverse or temporary harm event during their stay.
And 12% experienced events that led to longer stays, lifesaving interventions, permanent harm, or death. “This projects to 121,089 Medicare patients having experienced at least one adverse event during the 1-month study period,” the report stated.
Source: One in Four Medicare Patients Harmed in Hospitals, Nearly Half Preventable | MedPage Today
The Center for Medicare & Medicaid Services does a comprehensive look at hospital practices and that is why there is a lot of data for Medicare patients. There are other ratings for overall people in hospitals and rankings of hospitals by various complications and adverse events. It’s not easy to compare side by side for Medicare and private insurance. The bad news for me is I’m on Medicare and looking at a joint replacement. At an average rated hospital no less. The adverse event totals really should be made a priority for improvement, starting now. There is no reason for people to suffer from poor care due to hospitalization in such large numbers.
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What are the data for everyone else – those who are under age 65 and not disabled? Are the data different for those over age 65 who are not covered by Medicare Part A Hospital Insurance? And, if we don’t have comparable statistics for those of the same age to confirm that there is a difference based on insurance, why not? Are they hiding something? What if, in fact, one in four who ends up in a hospital, regardless of age, disability or coverage ends up with an adverse event?
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From years ago, I remember that Medicare had penalties for readmissions. So I google it. “Medicare counts as a readmission any of those patients who ended up back in any hospital within 30 days of discharge, except for planned returns like a second phase of surgery. A hospital will be penalized if its readmission rate is higher than expected given the national trends in any one of those categories.” This is probably the only data set that is available since hospitals are getting penalized. Private plans might not share their data.
However, decades ago, while under a HMO plan my wife had same day surgery. They rushed her out the door within four hours. She went back via the emergency room about six hours later for a two day stay. Where is this kind of data being hidden?
My first response to doctors is that I’ll do what will the insurance pay before deciding on a plan of action. Do I really need this treatment or test or is the doctor padding the bill? If the insurance doesn’t pay for something it is a red flag for me to ask more questions. But during covid it became very clear to me and others who I have talked to that doctors no longer have your best interest. They were doing what they were being told. Most work for corporations now instead of owning their own practices. Some doctors licenses were being threaten if they went against the covid protocols. If you follow the money, hospitals are paid 20% more for Medicare covid patients under the CARES act. The percentage is a fact but I can’t nail down the amount because of conflicting “fact checker” articles.
So are the hospital administrators and bean counters incentivizing patient treatments resulting in an adverse events? Is it just a cost of doing business that is calculated into the hospital polices? Was there an incentive to send sick patients back to their nursing homes during the height of covid to only spread it more? I guess we won’t know until the 2020 / 2021 data comes out.
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