News: Adverse event rates decreased in patients hospitalized 2010-2019, study shows

Between 2010 and 2019, the United States saw a significant decrease in the rates of adverse events for patients admitted for acute myocardial infarction, heart failure, pneumonia, and major surgical procedures, a recent study in the Journal of the American Medical Association (JAMA) found. The researchers collected data from more than 244,000 hospitalized patients and measured four kinds of adverse events: adverse drug events, hospital-acquired infections, adverse events after a procedure, and general adverse events (e.g., hospital-acquired pressure ulcers and falls). There also was a significant decrease in the adjusted rates of adverse events for all other conditions from 2012 to 2019, the co-authors of the study said.

An increasing emphasis has been placed on patient safety in the last few decades, but as of 2013 the estimates of annual patient deaths due to medical errors had risen steadily, HealthLeaders reported. This study points to a notable shift in the opposite direction, with several key data points such as the following:

• From 2010 to 2019, adverse events for acute myocardial infarction decreased from 218 to 139 per 1,000 hospital discharges
• From 2010 to 2019, adverse events for heart failure decreased from 168 to 116 per 1,000 hospital discharges
• From 2010 to 2019, adverse events for pneumonia decreased from 195 to 119 per 1,000 hospital discharges
• From 2010 to 2019, adverse events for major surgical procedures decreased from 204 to 130 per 1,000 hospital discharges
• From 2012 to 2019, adverse events for all other conditions were unchanged at 70 adverse events per 1,000 hospitals discharges
• After adjustment for patient and hospital characteristics, there was a significant decrease in the relative risk of adverse events for all other conditions from 2012 to 2019
• For acute myocardial infarction, heart failure, pneumonia, and major surgical procedures, overall observed in-hospital mortality declined from 4.6% in 2010 to 2.7% in 2019
• For the all other conditions group, overall observed in-hospital mortality increased from 1.2% in 2012 to 2.2% in 2016, with the rate at 1.7% in 2019

Interpreting this data, the study said that these results coincide with major patient safety improvement initiatives launched during the study period, as well as new technologies, and general advances in care. The relatively low decrease in adverse events for all other conditions was attributed possibly to quality improvement efforts targeting the four condition groups with higher baseline adverse event rates.

“The only increase in adverse event rates was in the general adverse events domain for all other conditions patient group in 2014 to 2019,” the study noted, “and this finding may indicate a special need for new initiatives related to prevention of pressure ulcers and inpatient falls.”

Editor’s note: To read HealthLeaders’ coverage of this story, click here. To read the full JAMA study, click here.