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To: Nadine Carroll who wrote (164189)	7/24/2001 10:22:35 PM
From: puborectalis	Read Replies (1) \| Respond to of 769669

Study: Impact of Medical Mistakes Overestimated By Merritt McKinney NEW YORK (Reuters Health) - Despite reports that thousands of Americans die each year in hospitals as a result of medical errors, the impact of medical mistakes may be exaggerated, according to the results of a new study. The report does not question the rate of medical errors--or the importance of preventing mistakes--but it does suggest that hospitals are not the dangerous places for patients that they are sometimes thought to be. Concerns about medical errors in hospitals intensified when the Institute of Medicine (news - web sites) released a report in 1999 estimating that between 44,000 and 98,000 people die in US hospitals each year as a result of mistakes made by doctors, nurses, pharmacists or other healthcare workers. ``The numbers are undeniably startling,'' according to Drs. Rodney A. Hayward and Timothy P. Hofer of the Veterans Affairs (VA) Ann Arbor Healthcare System and the University of Michigan. ``They suggest that more Americans are killed in US hospitals every 6 months than died in the entire Vietnam War,'' Hayward and Hofer write in a report in the July 25th issue of The Journal of the American Medical Association (news - web sites). Although estimates about the frequency of medical errors has encouraged the development of new initiatives designed to improve patient safety, some experts suspect that the estimates are too high and that many of the deaths were not preventable. To test the reliability of statistics on medical errors, Hayward and Hofer trained a team of physicians to review the cases of 111 patients who died at seven VA hospitals. The researchers excluded terminally ill patients who were receiving care meant to make them more comfortable, not cure them. The physicians were asked to rate the quality of care each patient received, and to decide whether better hospital care could have prevented a patient's death. Doctors also rated the odds that each patient would have lived at least 3 months after being discharged from the hospital, if he or she had received the best possible care. The physician reviewers also estimated the chances of having a good quality of life, both physical and mental, after being sent home from the hospital. As was the case in previous studies of medical errors, the physician reviewers estimated that better care might have prevented about 23% of deaths. Doctors thought that about 6% of the deaths were probably or definitely preventable. But the percentage of patients expected to survive dropped after the researchers took into account two factors--the range of opinions the doctors had about each patients' survival odds as well their estimates of patients' quality of life if they survived for 3 months. After making these considerations, Hayward and Hofer calculate that only 0.5% of all patients who died would have been expected to survive at least 3 months with a good command of their mental abilities. ``While deaths due to medical errors are still extremely important even when patients have very short life expectancies, the correct understanding of these errors may differ substantially from how they have been publicly portrayed to date,'' Hayward and Hofer conclude. ``Our study suggests that the previously reported statistics have been misunderstood,'' Hayward told Reuters Health. ``Both the likelihood that a true error had occurred and the likelihood that an error caused the death have probably been dramatically over-estimated.'' It is important for the public to know, according to Hayward, that most of the ``errors'' reported in studies that review patients' medical charts ``represent difficult medical decisions in very ill people.... In such instances, some physicians will feel that an error occurred and others will not.'' He noted that most of the apparent errors represent instances when a physician reviewing the medical record felt that a patient did not receive enough care. ``We found no instances of egregious mishaps, like inadvertent administration of the wrong medication,'' Hayward said. SOURCE: The Journal of the American Medical Association 2001;286:415-420.

To: Nadine Carroll who wrote (164189)	7/24/2001 10:24:44 PM
From: puborectalis	Respond to of 769669

The United States, which represents 4 percent of the world's population but has the largest single economy, produces about 25 percent of the planet's greenhouse gases.