Efforts To Improve Patient Safety Result in 1.3 Million Fewer Patient Harms

Interim Update on 2013 Annual Hospital-Acquired Condition Rate and Estimates of Cost Savings and Deaths Averted From 2010 to 2013

Exhibit A4 contains projections of the estimated impact of the initiative that would be launched in April 2011 as the "Partnership for Patients." Several projections were needed for each of the types of hospital-acquired conditions (HACs) that were selected for special focus. For each HAC, the incidence, preventability, cost, and additional mortality were assessed; and a goal was set as to the percentage of preventable HACs to be prevented.18 These assessments and the associated projections are provided below in Exhibit A4.

The basis of the derivation of the overall 44 percent preventability estimate (which corresponds to the previously referenced 2010 OIG estimate) is shown in the table, as is the basis for the PfP goal of a 40 percent reduction in preventable HACs. Also shown is the estimate that, if 44 percent were considered preventable, the overall PfP goal to prevent 40 percent of preventable HACs would result in reducing the overall rate of HACs by approximately 17 percent.

The sources of the estimates in Exhibit A4 were identified based primarily on peer-reviewed articles published through early 2011. Other sources included reports and other information from HHS and other federally sponsored programs, and expert opinions.

Complete references to the documents accessed to make these assessments and projections, organized by HAC type, are provided at the end of this document. In general, all references listed were available in early 2011, except for several documents that were available only in a draft form prior to the launch of the PfP in April 2011; in these cases the final document is listed.

Exhibit A4. Estimates, Goals, and Projections for HACs at the Launch of PfP initiative in 2011

PfP Hospital-Acquired Condition Estimated U.S. National Incidence of HACs (2010) Estimated HAC Preventability as of 2010/2011 PfP Goal at Launch of Program (Percentage of Preventable HACs) Combined Goal for HAC Reduction (Preventability x Goal) PfP HAC Reduction Goal (Fewer HACs in 2014* vs. 2010 Baseline) Estimated PfP Additional Cost* per HAC Estimated PfP Additional Inpatient Mortality per HAC Projected PfP Cost Savings in 2014 if 2014 Goal Met Projected Reductions in Deaths Associated With HACs in 2014 if 2014 Goal Met
Adverse Drug Events 1,900,000 50% 50% 25% 475,000 $5,000 .020 $2,375,000,000 9,500
Catheter-Associated Urinary Tract Infections 530,000 40% 50% 20% 106,000 $1,000 .023 $106,000,000 2,470
Central Line-Associated Bloodstream Infections 40,000 50% 50% 25% 10,000 $17,000 .185 $170,000,000 1,850
Falls 200,000 25% 50% 12.5% 25,000 $7,234 .055 $180,850,000 1,375
Obstetric Adverse Events 380,000 30% 50% 15% 57,000 $3,000 .0015 $171,000,000 84
Pressure Ulcers 250,000 50% 50% 25% 62,500 $17,000 .072 $1,062,500,000 4,525
Surgical Site Infections 110,000 35% 20% 7% 7,700 $21,000 .028 $161,700,000 217
Ventilator-Associated Pneumonias 40,000 50% 50% 25% 10,000 $21,000 .144 $210,000,000 1,438
(Post-op) Venous Thrombo-embolisms 100,000 40% 50% 20% 20,000 $8,000 .104 $160,000,000 2,080
All Other HACs 2,430,000 44% 25% 11% 267,300 $17,000 .045 $4,544,100,000 12,109
Totals 5,980,000 44.1% 39.3% 17.4% 1,040,500 NA NA $9,141,150,000 35,647



* Additional costs per HAC for Falls and Pressure Ulcers were modified in 2012 from earlier higher projections. The earlier estimates had been wrongly based on the full cost of a hospital stay that included a fall or a hospital-acquired pressure ulcer, rather than on the incremental cost due to the HAC.

 


18. In 2011, this work was completed using the best available information to generate 2010 incidences and other information regarding the HACs. After these estimates were made, processes were established to measure and estimate national HACs starting with a 2010 measured baseline (4,757,000 HACs).  In order to produce consistent estimates of cost savings and deaths averted for 2010 to 2013, the per-HAC estimates established for the costs and deaths associated with HACs in 2011 have not been modified.




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Page last reviewed December 2014
Page originally created December 2014
Internet Citation: Interim Update on 2013 Annual Hospital-Acquired Condition Rate and Estimates of Cost Savings and Deaths Averted From 2010 to 2013. Content last reviewed December 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/professionals/quality-patient-safety/pfp/interimhac2013-ap4.html
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