A study published in JAMA and funded and carried out by Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) shows that rates of in-hospital adverse events for healthcare related patient harm fell significantly in the U.S. in the decade prior to the onset of the Covid-19 pandemic. Researchers found significant decreases in in-hospital adverse event rates for heart attack, heart failure, pneumonia, and major surgical procedures. After reviewing records of nearly 245,000 patients in more than 3,100 hospitals between 2010 to 2019, this study shows that pre-Covid hospital care was getting safer.
Researchers of this study tracked a total of 21 adverse events over the study period. Examples of the events included adverse medication events such as those associated with the use of insulin or anticoagulants, infections such as central line-associated bloodstream infections and catheter-associated urinary tract infections, and post-procedure events such as those associated with hip joint or knee joint replacement surgeries or postoperative cardiac events.
This analysis is the most comprehensive evaluation to date of adverse events that occurred in hospitalized patients in the United States. Adverse events are often defined as physical or psychological harm caused by a person’s interaction with the healthcare system (rather than the underlying disease) that may result in prolonged hospitalization, pain, discomfort, a disability, or even death. Tracking the rates of adverse events is a common way of measuring changes in patient safety.
In the study, researchers examined the rates of adverse events by looking at the raw (observed) rates of adverse events and looking at rates after adjustment for changes in the patient populations and hospitals included in the study over a 10-year period. In the observed data for 2010 and 2019, adverse event rates fell 36% for heart attack patients, 31% for heart failure patients, 39% for pneumonia patients, 36% for major surgery patients, but were unchanged for the group of patients representing all other conditions. After adjustment, the relative risk of experiencing an adverse event diminished for all five patient groups, as follows: 41% for heart attack patients, 27% for heart failure patients, 36% for pneumonia patients, 41% for major surgery patients, and 18% for patients with all other conditions.
• Lire : Eldridge N and al. Trends in adverse event rates in hospitalized patients, 2010-2019. JAMA. 2022;328(2):173-183. Doi : 10.1001/jama.2022.9600.