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The U.S. healthcare system offers millions of patients access to healthcare that is provided by highly skilled, committed professionals and first-rate institutions. It also affords the advantages of the latest innovations in research, technology, and treatment. At the same time, the system is marked by serious and pervasive deficiencies in quality. Quality problems affect all patients, regardless of age, gender, financial resources, or race. In addition, quality problems cut across the delivery system, and are not the result of any single financing or payment arrangement. Quality deficiencies result in increased mortality and morbidity and in failure to alleviate conditions that cause pain and disability, leading to a lower quality of life, a less productive workforce, and billions of dollars in unnecessary costs.
Tremendous geographic variation in the use of clinical procedures suggests the scope of quality deficiencies. Relying on a growing body of research, quality experts have identified three other principal indicators of quality problems:
Error Rates. Inadequate diagnosis and treatment cause unnecessary mortality and morbidity, increasing the burden, complications, and cost of treatment.
According to the Institute of Medicine at least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented. Even using the lower estimate, preventable medical errors in hospitals exceed attributable deaths to such feared threats as motor-vehicle wrecks, breast cancer, and AIDS.
Overtreatment. Millions of patients receive treatments each year that they do not need, leading to complications, reduced productivity, and significantly higher costs. Experts estimate that approximately 20 to 30 percent of healthcare treatments are unnecessary.
Overuse has been well documented for numerous types of invasive surgery and tests; an estimated 16 percent of hysterectomies and 17 percent of coronary angiograms performed each year are unnecessary.
Undertreatment. Studies consistently show the failure to provide effective treatments, ranging from life-saving interventions that can reduce mortality, such as taking aspirin to lower the risk of heart attack, to vaccinations that prevent serious illness in the elderly and children.
Only an estimated 50 percent of patients receive recommended preventive care.
Among individuals suffering from depression, 59 percent are not treated and 19 percent receive ineffective treatment, leading to an estimated $12 billion annual loss in employee productivity.
Serious Reportable Events. The United States pays a high price for medical errors, not just financially, but in resources and lives. In 2002, The National Quality Forum (NQF) created and endorsed a list of serious reportable events (SREs) to increase public accountability and consumer access to critical information about healthcare performance.
There are 28 events and each is classified under 1 of 6 categories: surgical, product of device, patient protection, care management, environment, or criminal.
Please click here to access the Serious Reportable Events Fact Sheet.
Please click here to access the Serious Reportable Events Report.