Slashdot Mirror
Medical Errors Are Number 3 Cause of US Deaths, Researchers Say (npr.org)
An anonymous reader quotes a report from NPR: A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third-leading cause of death in the United States -- and highlights how shortcomings in tracking vital statistics may hinder research and keep the problem out of the public eye. The authors, led by Johns Hopkins surgeon Dr. Martin Makary, call for changes in death certificates to better tabulate fatal lapses in care. In an open letter, they urge the Centers for Disease Control and Prevention to immediately add medical errors to its annual list reporting the top causes of death. Based on an analysis of prior research, the Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors. On the CDC's official list, that would rank just behind heart disease and cancer, which each took about 600,000 lives in 2014, and in front of respiratory disease, which caused about 150,000 deaths. Medical mistakes that can lead to death range from surgical complications that go unrecognized to mix-ups with the doses or types of medications patients receive. The study was published Tuesday in The BMJ, formerly the British Medical Journal.
We spend so much money for so little.
Is the worst in the world. Cuba is the best, by far.
"250,000 Americans die each year from medical errors"
Fuck fighting terrorism. This deserves more attention.
When you look up the rates for problems, you see huge % of the staff have problems.
The non-stop pressure from management to work faster coupled with major decisions being made with often not enough diagnostics or time means burnout is high and part of that is the recognition they make mistakes.
A friend who works the ED noted he had an inconclusive diagnosis of a new patient and took extra time to get other tests done. He got the results and the patient was moved into the hospital and he was on to his next patient when a 'bean counter' shows up and says "We noticed you took an extra 20 minutes on your last patient. You are slowing down. etc. etc."
Then to counter the stress and sometimes double shifts, they start taking drugs.
People vastly overestimate how infallible people are (especially themselves). The rate at which humans make errors is about 0.5%. Which if you think about all the things you do in the course of a day, is a really big number.
About 7.3% of the population were hospitalized overnight or longer (23 million people).
If 250,000 of them died, then fatality rate due to medical errors is about 1.1%. Which is in line with the average error rate compounded over multiple ways in which errors could kill a hospital patient.
If you want to reduce the fatality rate, you either need to get people out of the system (e.g. autonomous cars - but they make people uncomfortable even though they're statistically safer), or implement automated checks to supplement people's work. We're already doing the latter with prescriptions - computers now automatically check for dangerous interactions between medications prescribed to the same person. More operating rooms scan all equipment used during surgery, and re-scans at the end to make sure it's all accounted for, and nothing has accidentally been left inside the patient. And some hospitals are starting to use barcode and RFID scanners to double-check that the medication being administered is the proper one for that particular patient.
I work for the single payer health care system of Finland on the administrative side (IT & stats related) and partly because of that, health care has always been one of my favorite subjects to discuss. However something I've noticed when talking with Americans about it is a certain type of illusion/fallacy that many seem to be under, which is that because you pay so much for it, it must be the best system out there.
Just yesterday I had a lengthy conversation on fb about the problems with a purely insurance based model, and even though I tried linking a couple of studies as to the amount of deaths caused by lack of access due to costs, I was labeled a liar because apparently 'everyone in the US now has the opportunity to get health insurance" (a direct quote from him) despite the fact that it's known that there are people who do not meet the criteria under the ACA to qualify for the cheaper/low income insurances whilist also not being able to afford a private one AND that there are also still issues with insurances not covering certain operations. Don't get me wrong, the ACA was a small step in a better direction but the gutting of the public option for all sort of killed the best potential about it. Yet my counterpart in said discussion was adamantly of the opinion that anyone who dies in the US for not getting treatment dies purely because he/she didn't bother to get insurance and hence the system is not to blame.
You've plenty of things where you lead the world, and the medical R & D and high level expertise in the US is unparalleled. However I do wish that more Americans would realize how much you're paying for simple base level health care. I've seen hospital invoices from the states where simple over the counter ibuprofen pills are billed at several dollars a piece. That's a a margin of several thousand percentages. The fact that this is allowed is unfathomable to me. Even if one is of the opinion that a life-saving basic service should be allowed to remain a profit-driven business, having no controls on pricing combined with the insurance lobby has created a gigantic price bubble. This is why the US spends combined (private and tax spending) the most money on the planet per capita on health care, and still the results are far from the top. (Source (wiki))
The profit motive needs to be either removed or curtailed heavily, so that more of the money that's spent can actually be used to improve the level of care and oversight, instead of just increasing the profits of the insurance giants and private hospitals.
We get comparable treatment results and universal coverage (at about 3500 dollars a year per capita) than the US does when it comes to life expectancy, cancer survival rates (in fact, with certain types of cancers we're ahead of the US even) and so on. You spend more than DOUBLE that (8700 dollars according to OECD when totaling private and public spending, though interestingly, the CDC puts this figure even higher at 9500) and the massive increase in spending doesn't get you the kind of results that such an investment should.
You could and should easily be able to arrange for the hands down best universal health care system without spending a dime more than you already are. Don't spend more, spend smarter.
Just my 2 cents, feel free to mod me down for being a socialist scum now.
"It is the business of the future to be dangerous" -Alfred North Whitehead
1) eliminate the health care companies. We need direct pay!
The costs are too large to not have either insurance companies or the government involved. The majority of Americans would be bankrupted by a single major surgery and that would be true even if healthcare costs weren't completely out of hand.
2) eliminate the AMA. There are not enough doctors. Patients are dying in the emergency room waiting to be seen.
First off, the AMA has nothing to do with the quantity of doctors. They do not directly control the supply of doctors and in fact the number of medical schools has been increasing in the last decade. Second, there is no epidemic of patients "dying in the ER waiting to be seen". Emergency Departments (they aren't typically called Emergency Rooms because - well, they're not a room) are actually quite good at triaging patients and taking care of those in greatest need first. There is however the problem of people coming to the Emergency Department for conditions that clearly are NOT emergencies because our screwed up system gives them no other options.
3) kill all malpractice lawyers. A doctor practising in good faith should never ever be sued
And exactly how do you plan to distinguish between doctors acting in good faith and those that aren't? While the vast majority of doctors are good, hard working people who care greatly about their patients, there are exceptions. Furthermore there sometimes are doctors of questionable competence. An incompetent person acting in good faith is just as dangerous as a competent person acting in bad faith. Either one is dangerous and there has to be a mechanism for dealing with them.
4) curtail the power of the FDA. The FDA does more harm than good.
Spare me. While nobody would argue that the FDA is without problems, the FDA is one of the most successful and vital government organizations we have. Their prime directive is to actually make sure that medical treatments actually work before they can be sold to the public. Without the FDA you would have absurd levels of quackery and fake "treatments" being sold to people who don't know any better. One merely has to look at the market for "alternative medicine" (particularly homeopathy) to see what would happen. You know what they call alternative medicine that is proven to work? Medicine.
There is no difference between big government and big corporations. You do not want you health care being run by the insurance companies or the government.
If you think there is no difference between government and business you don't understand either one adequately. There are no other payment options available without involving either insurance or government. Most countries have (sensibly) picked the government option since EVERYONE needs health care at some point but insurance can be made to work. But unless you are privately wealthy there aren't any third options. Your notion of everyone paying directly is pure fantasy because the costs are and will remain too high to be feasible.
A friend's wife is senior management with a hospital system and we were talking about some of the impossible challenges of medical care and cost.
I kind of wondered if more opiates, doled out in small doses & quantities, wasn't actually partly the answer.
1) Pacifies the hypochondriacs and people with vague and poorly defined "symptoms" who end up getting a bunch of expensive tests to rule out rare conditions they don't have. They go home, feel better from the opiates and maybe find something else to be distracted about because they feel better. Eliminates a lot of doctor time, lab time and expensive time on limited access equipment like MRIs.
2) Masks symptoms in people who have chronic conditions and have no actual cure. These people may have expensive and marginally effective therapies for what actually ails them, but quite often these are expensive drugs, demanding physical therapies or other treatments that don't much improve their actual condition or how they feel and won't cure them anyway. A lot of the time is strikes me that these people are on expensive medications with weird side effects and marginal primary effects whose principal value seems to be they aren't opiates.
OK, there would be downsides, some of these people would develop low-level habits, but that's where the small doses and quantities part comes in. Given opiates under managed conditions, most would not spiral into raging junkies and many may actually experience an improved quality of life because they *feel* better. Even if they did have low-level, maintenance habits they could be on opiates for years without any significant side effects, and as drugs they are dirt cheap.
The up side is that a lot of people who clog the medical system with non-problems and conditions that mainly need to be managed to keep them living functional lives, probably saving a bunch of money and resources for people with treatable or more life-threatening conditions.
In a way, it's kind of a rationing of medical resources but with potential state-of-mind improvement for those rationed out of the system.