Medical error is the third largest cause of death in the US, according to a study published in The BMJ.
After analyzing medical death rate data over an eight year period, Johns Hopkins researchers found that more than 250,000 people die in the U.S each year as a result of medical error, making it the third biggest cause of death after heart disease and cancer.
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Martin Makary and Michael Daniel (John Hopkins University School of Medicine, Baltimore) say that death certificates in the US do not acknowledge medical error and that new criteria for classifying deaths on the certificates is needed.
“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” says Makary.
“The medical coding system was designed to maximize billing for physician services, not to collect national health statistics.”
Currently, death certification in the US involves an International Classification of Disease (ICD) code being assigned for the cause of death. Therefore, deaths that are not associated with such a code fail to be captured.
Makary says that at the time the U.S. adopted this use of ICD billing codes, the potential for diagnostic errors, medical mistakes and the absence of safety nets to result in death was under recognized: “Because of that, medical errors were unintentionally excluded from national health statistics.”
For the study, the researchers looked at four analyses of medical death rate data published between 2000 and 2008. They then used 2013 hospital admission data and extrapolated that, based on the total number of hospitalizations during this time (35,416,020), the mean death rate due to medical error was 251,454 per year.
According to the annual list of most common causes of death in the US, compiled by the Centers for Disease control and Prevention, 611,105 people died of heart disease in 2013, while 584,881 died of cancer and 149,205 died of chronic respiratory disease. This puts medical errors as the third most common cause of death; behind heart disease and cancer, but ahead of respiratory disease.
Makary says: “Top-ranked causes of death as reported by the CDC inform our country’s research funding and public health priorities. Right now, cancer and heart disease get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.”
The researchers acknowledge that a certain level of human error is inevitable. However, they say “we can better measure the problem to design safer systems mitigating its frequency, visibility, and consequences,” and that more research into preventing medical errors arising is needed to address the problem.