Did the ACA really result in 50,000 fewer patient deaths?

President Barack Obama's recent claim that the Affordable Care Act (ACA) has led to 50,000 fewer preventable patient deaths may be based on "an estimate of an estimate," but it is likely that he is correct about the healthcare reform law's ability to reduce patient harms, according to the Washington Post's Fact Checker blog.

Obama made the statement during a recent White House event that marked the start of the Health Care Payment Learning and Action Network and celebrated the five-year anniversary of the ACA. The figure is based on a Department of Health and Human Services (HHS) report released in December 2014, which estimated that government initiatives such as the ACA-mandated Partnership for Patients resulted in 1.3 million fewer hospital-acquired conditions such as adverse drug events, catheter-associated urinary tract infections, central line associated bloodstream infections, pressure ulcers and surgical site infections between 2011 and 2013, FierceHealthcare previously reported.

However, the report itself notes that "the precise causes of the decline in patient harm are not fully understood." The 50,000 deaths figure is especially problematic because it an estimate of avoided deaths that itself is based on an estimate of avoided incidents, noted the Post. "There is some uncertainty about these estimates," one administration official told the newspaper. "In some cases, the literature [on excess mortality] is better than others."

It is even more difficult to determine whether the industry can directly trace the reduction in patient harms to the ACA, especially given that a Centers for Disease Control and Prevention report found that inpatient deaths have been on the decline since 2000, the Post noted. Still, funding provided by the ACA as well as the Partnership for Patients initiative spurred thousands of hospitals to share and promote already-effective best practices, thus driving down patient harms even further, another official told the Post.

Ultimately, while Obama could have better worded his statement to reflect some of the uncertainty in the 50,000 deaths estimate, the ACA likely did build upon work that predated it to help significantly reduce patient harms, so the president's statement is essentially true, the Post concluded.

That does not mean that the administration thinks its work to improve healthcare is done, however. HHS Secretary Sylvia Burwell noted when her agency's report was released that the 17 percent decline was "only a start," according to FierceHealthcare. "No American should ever lose his or her life, or spend the holidays in the hospital because of a condition that could have been prevented," she said.

To learn more:
- read the blog post

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