Study: Preventable complications add $2B in hospital costs

Close up of senior woman holding senior man's hand at his bedside in a hospital setting
Hospital-acquired conditions like pressure sores, falls and surgical site infections resulted in more than $2 billion in excess hospital costs in 2016, a new study found. (Getty Images/KatarzynaBialasiewicz)

Hospital-acquired conditions like pressure sores, falls and surgical site infections resulted in more than $2 billion in excess hospital costs and more than 3,200 potentially avoidable deaths in 2016, according to a study from IBM Watson Health.

In all, the study found, there were nearly 49,000 cases of hospital-acquired conditions in 2016 that were considered potentially avoidable despite quality measures meant to track the complications tied to potential financial penalties.

"Sometimes by having penalties in place and by simply measuring quality, we simply can't expect we're going to expect we might eliminate avoidable complications that might arise in a hospital," IBM Watson Health's chief health informatics officer, Anil Jain, M.D., told FierceHealthcare in an interview. "More needs to be done."

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To perform the study, the group examined data from the 14 categories of hospital-acquired conditions tracked by the Centers for Medicare and Medicaid Services using the 2016 IBM Watson Health Projected Inpatient Database, which includes claims data from payers nationwide, representing about 20 million discharges from more than 2,600 acute care hospitals.

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The researchers also found avoidable complications add an average of eight days to patient length of stay and increase mortality risk by 72%, he said.

"Simply telling hospitals if they don't achieve these types of targets, that they will have decreased reimbursement still has resulted in what we would consider to be excess mortality and excess cost," said Jain, who is also a practicing physician at Cleveland Clinic.

RELATED: Half of hospitals in Connecticut, Delaware hit by Medicare’s safety penalties

It's among a number of recent studies which showed persisting complications in hospitals, although there was a more positive perspective on the problem released by the Agency for Healthcare Research and Quality in the spring. Its National Scorecard on Hospital-Acquired Conditions estimated that efforts to cut patient safety risks such as adverse drug events or falls saved 8,000 lives and $2.9 billion between 2014 and 2016.

While it's not necessarily fair to expect health systems to reach zero on these numbers, Jain said the IBM Watson Health study is a starting place for a dialogue for hospitals about how to improve, he said. Some of the next steps are to dig into the data further about the trends of these complications and whether hospitals are making better progress on reducing some compared to others, he said.

"Let's put some programs in place where we help hospitals actually figure out how they're comparing with their colleagues, what processes are actually improving outcomes in one particular unit versus another," he said.

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