Hospital-acquired condition rates down but not as significant as first appears

Efforts to reduce hospital-acquired conditions (HACs) have led to 87,000 fewer patient deaths and nearly $20 billion in healthcare cost savings over a four-year period, according to a new report released by the Department of Health and Human Services. But the findings may not be as significant as they seem.

Although federal officials lauded the findings from the Agency for Healthcare Research and Quality (AHRQ), patient safety experts interviewed by Kaiser Health News said that while hospitals have made progress, the preliminary 2014 data isn't as impressive as it may initially appear. Indeed the findings were similar to an AHRQ report released last month that showed hospital complications were 17 percent lower in 2013 than 2010. But the 17 percent decline is the same statistic cited in the latest report that includes 2014 data.

"We are still trying to understand all the factors involved, but I think the improvements we saw from 2010 to 2013 were very likely the low-hanging fruit, the easy problems to solve," Richard Kronick, Ph.D., director of the federal AHRQ, told KHN.

The most recent report analyzed the number of avoidable HACs compared to 2010 rates, using as a baseline estimates of deaths and excess healthcare costs developed when the federal government launched its Partnership for Patients program, according to the report announcement.

Although the report shows progress in reducing the number of HACs, the authors noted that much more work is necessary to ensure the U.S. healthcare system is as safe as possible. The data from 2013 to 2014, which show a 17 percent reduction in HACs, indicate additional patient safety efforts are needed, according to the report.

The interim 2014 estimates find that more than 36,000 fewer patients died in hospitals in 2014 due to the decline in HACs compared to the number of deaths that would have occurred if the rate of HACs remained at 2010 levels. Most of those deaths were prevented due to fewer incidences of pressure ulcers and adverse drug events, according to the report.

"Those are real people that are not dying, getting infections or other adverse events in the hospital," Patrick Conway, M.D., chief medical officer for the Centers for Medicare & Medicaid Services, told KHN.

The report also found significant progress in other areas:

  • A 72 percent reduction of infections from central lines inserted into veins
  • A 38 percent reduction of infections from urinary catheters
  • An 18 percent drop in surgical site infections

However, Conway noted in the KHN article that although the reductions in those areas exceeded federal goals, hospitals were motivated to cut these types of infections because of Medicare incentives and penalties.

To learn more:
- read the announcement
- here's the report
- check out the KHN article