The cost of preventable medical errors exceeds $17 billion annually, with nearly half of these expenditures representing direct health care costs. Medical errors, by some estimates, are the eighth leading cause of death in the United States. In addition to health care expenses and the costs associated with untimely mortality, the cost of medical mistakes includes lowered workplace productivity, unnecessary absences, and an increased incidence of disability.
The scope of “medical errors” is broad. According to a report from the Institute of Medicine (IOM), medical errors fall into these categories:
- Diagnostic errors — Mistaken or delayed diagnosis; failure to use an indicated diagnostic test; use of an outmoded test or therapy; failure to take action as a result of patient monitoring or test results.
- Treatment errors — Mistakes made during an operation, procedure or test; mistakes in administering a treatment; incorrect prescribing or dosing of medication; delaying treatment in response to an abnormal test result; providing care that is not indicated.
- Preventive errors — Failing to provide prophylactic treatment; inadequately monitoring or following up.
- Other errors — failing to communicate; equipment failure; other system failure.
Most data on medical mistakes centers on errors that occur in the hospital setting. For example, the IOM estimates that 44,000 to 98,000 people die each year in hospitals as a result of medical mistakes, and a report from HealthGrades found that Medicare patient safety events and deaths resulting from hospital errors cost approximately $2.0 billion from 2005 through 2007. In contrast, little data exists on the extent of medical mistakes made in physicians’ offices, nursing homes, pharmacies and urgent care centers, and in the course of home health care.
Though much of the cause of medical errors is systemic, employers can play a role in reducing the incidence of such errors. According to the IOM report, by raising expectations for improvements in safety and for health care providers’ performance, purchasers of health care — including employers — can impact patient safety positively and thereby lessen the chances of errors occurring. One way employers can do this is by making safety a primary factor in the contracting decision process.
Employers can also contribute toward lowering the rate of medical errors by communicating actively the importance of the issue to employees. With employer group health plans being a major purchaser of health care in the United States, this puts employees and dependents who use this care on the front lines of battling medical mistakes. The IOM notes that, for example, in the case of errors involving medications, patients can provide a major safety check in hospitals, clinics and physicians’ offices. Patients should know which medications they’re taking, what their medications look like, what their usual dose is, and what possible side effects can result, and notify their doctor immediately if they notice anything seemingly wrong with their prescription or any side effects. Resources on patient safety are available on the Web site of the Agency for Healthcare Research and Quality, http://www.ahrq.gov/qual/errorsix.htm.
Talking to employees about the role they can play in this regard — in a company newsletter article, in benefits communications materials, or during a lunchtime presentation — can impress on them that by being an active participant in their health care, they can lessen the chance that they will be a victim of a medical mistake. Reducing the incidence of mistakes can help to control costs for both an employer and employees, and can improve employee patient safety substantially.