Nearly 1 in 4 patients who are admitted to hospitals in the U.S. will experience harm, according to a study published Wednesday in the\u00a0New England Journal of Medicine.
\nThe stark findings underscore that, despite decades of effort, U.S. hospitals still have a long way to go to improve\u00a0patient safety, experts say.
\n\u201cThese numbers are disappointing, but not shocking,\u201d said Dr. David Bates, the chief of general medicine at Brigham and Women\u2019s Hospital in Boston, who led the study. \u201cThey do show we still have lots of work to do.\u201d
\nThe research looked at the medical records of 2,809 patients who were hospitalized in 11 Boston-area hospitals in 2018. The study excluded people who were admitted for observation only or for hospice, rehabilitation, addiction treatment or psychiatric care.
\nHospital data showed that 663 of the patients \u2014 about 24% \u2014 experienced at least one event during their stays that negatively affected their health, even temporarily.
\nA total of 222 adverse events were considered preventable, meaning\u00a0errors resulted in patient harm. That translates to about 7% of the total admissions the researchers analyzed. Twenty-nine people, or 1% of the total of those admitted, experienced serious preventable adverse events that resulted in serious harm. One death was considered preventable.
\nThe majority of the bad outcomes, however, were deemed unpreventable. They can include\u00a0known side effects from certain medications\u00a0or known risks associated with surgery.
\nThe most common adverse events overall (nearly 40%) were related to medications given in the hospital. Surgery and other procedures accounted for just over 30%, followed by what the study authors called \u201cpatient-care events,\u201d at 15%. They include falls and bedsores, both of which are considered preventable.
\nOne bright spot, experts said, was that\u00a0infections acquired in the hospital\u00a0accounted for only about 12% of the adverse events \u2014 a significant decrease from a 1991 study that found infections were the second-most-common adverse event.
\nThe 1991 study, called the\u00a0Harvard Medical Practice Study I, is considered landmark research. Using data from patients hospitalized in New York state in 1984, it found that only about 4% of hospitalized patients experienced harm. However, the study looked for a smaller range of adverse events than the current research, and hospitals have become much better at reporting harm when it does occur.
\n\u201cIt\u2019s clear that, at least, the rate is not going down and that harm continues to be a really serious issue,\u201d Bates said.
\nDr. Albert Wu, the director of the Center for Health Services and Research Outcomes at the Johns Hopkins Bloomberg School of Public Health, said in an email that while progress has been made in some areas, new risks have emerged as medicine has advanced.<\/p>\n