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Burden of Inpatient Safety and Adverse Outcomes
August 2017
Hospitals and payers are focused on preventing and reducing the health and cost consequences of the adverse events so starkly highlighted by the Institute of Medicine’s 1999 seminal report on patient safety, To Err Is Human.
Adverse events are defined as either the failure of a planned action to be completed as intended, or the use of a wrong plan to achieve an aim. In 1999, the total cost of these events, including indirect costs, was estimated to be as high as $29 billion a year. In the United States, patient safety continues to be a priority, as part of a drive toward value. Patient safety events can directly impact hospital revenue. CMS’ Hospital-Acquired Condition Reduction Program penalizes reimbursements by 1% for hospitals achieving the bottom quartile in performance scoring.
This study presents the incremental consequences of selected inpatient medical injuries as identified by the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (in terms of mortality, length of stay, and total hospital cost per case among national U.S. inpatients), and quantifies the estimated overall impact of such events at the national level.
With premiums on the rise and commercial payers interested in increasing the value return on their healthcare investment, more payers are considering value-based care arrangements.
While CMS has led the charge to use bundled payments for joint replacements through the Bundled Payments for Care Improvement (BPCI) and Comprehensive Care for Joint Replacement (CJR) program, there is increasing interest in these arrangements from the payer market.
As payers and providers begin to anticipate and plan for the change,it’s important to study bundled payments from a variety of angles looking at cost variations by region, market, provider type, and payers.
The Truven Health Analytics™ 15 Top Health Systems study is an ongoing research project that is adjusted as changes occur in the healthcare environment, newly public data and metrics become available, and managerial practices evolve.
The Truven Health Analytics™ 15 Top Health Systems measures relative balanced performance across a range of organizational key performance indicators— reflecting care quality, use of evidence-based medicine, postdischarge outcomes, operational efficiency, and customer perception of care. This analysis provides valuable guidance to health system boards and executives who use these critical, quantitative performance insights to adjust continuous improvement targets,ensure the collaboration of member hospitals, and achieve systemwide alignment on common performance goals.
Winners of the Truven Health Analytics™ 100 Top Hospitals® designation demonstrate how effective leaders manage change and achieve excellence in a dynamic environment. Using the measures presented in our National Balanced Scorecard, this year’s 100 Top Hospitals® study revealed significant differences between award winners and their nonwinning peers.
The nation’s top-performing hospitals had lower inpatient mortality, considering patient severity; had fewer patient complications; followed accepted care protocols for stroke care and blood clot prevention; had lower 30-day mortality and 30-day readmission rates; sent patients home sooner; provided more timely emergency care; kept expenses lower, both in-hospital and through the aftercare process; and scored 10 points higher on patient ratings of their overall hospital experience.
