Chronic lower respiratory disease is currently listed as the third leading cause of death in the United States by the Centers for Disease Control and Prevention (CDC). Respiratory disease kills close to 150,000 people each year, and fall behind cancer, which kills nearly 600,000 people per year. However, new research published in The BMJ found that “medical errors” are responsible for more than 250,000 deaths a year in the U.S., surpassing respiratory disease as the third leading cause of death.
“People don’t just die from heart attacks and bacteria, they die from system-wide failings and poorly coordinated care,” lead author Dr. Martin Makary, a professor of surgery and health policy at Johns Hopkins University School of Medicine, told U.S. News & World Report. “It’s medical care gone awry.”
Researchers from Johns Hopkins University analyzed medical death rate data over an eight-year period to come up with this figure. Based on the prevalence of deaths due to medical errors, the Johns Hopkins team believes the CDC should classify medical errors separately on death certificates when they collect national health statistics. The researchers are essentially advocating for an updated criteria for classifying deaths.
“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” Makary said in astatement. “The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used.”
In 1949, the U.S. adopted an internationally-used form called the International Classification of Diseases (ICD), essentially billing codes that help to tally deaths. Makary said medical errors weren’t included because there wasn’t yet the awareness that death could result from diagnostic errors, medical mistakes, “and the absence of safety nets.” As a result, medical error was “unintentionally” excluded from national health statistics.
Makary and his colleagues combed through four studies that looked at the medical death rate data from 2000 to 2008, including one by the Department of Health and Human Services’ Office of the Inspector General and the Agency for Healthcare Research and Quality. They then calculated hospital admission rates from 2013 and determined that based on a total of 35,416,020 hospitalizations, 251,454 deaths stemmed from medical errors, which the researchers say translates to 9.5 percent of all deaths each year in the U.S.
The results from this study put medical error behind cancer and ahead of chronic lower respiratory disease as the leading cause of death in the U.S.
“Top-ranked causes of death as reported by the CDC inform our country’s research funding and public health priorities,” Makary explained. “Right now, cancer and heart disease get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.”
It’s important to note that many medical errors aren’t the result of inherently bad doctors. Therefore, the researchers aren’t suggesting that reporting these errors be addressed by punishment or legal action. Researchers say they are aware that most errors represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted deviations from practical standards, which tend to lack accountability. One 2013 study found that 70 percent of medical errors can be blamed on technology and equipment failures.
“Unwarranted variation is endemic in health care. Developing consensus protocols that streamline the delivery of medicine and reduce variability can improve quality and lower costs in health care,” Makary said. However, further research will be needed to determine how best to prevent medical errors.
Source: Makary, M, Daniel M. Medical Error— The Third Leading Cause of Death in the US. The BMJ. 2016, Medical Daily
