Nationwide efforts to make health care safer are paying off, according to a report released by the Department of Health and Human Services (HHS). Thanks, in part, to provisions of the Affordable Care Act (ACA), approximately 125,000 fewer patients died due to hospital-acquired conditions (HACs), and more than $28 billion in health care costs were saved from 2010 to 2015.
In total, hospital patients experienced more than 3 million fewer HACs from 2010 to 2015—the result of a 21% decline in the rate of these adverse events over that period. The decline in their incidence aligns with a major goal of the ACA to improve the quality of health care, according to the new “National Scorecard on Rates of Hospital-Acquired Conditions” from the Agency for Healthcare Research and Quality (AHRQ).
HACs include adverse drug events (ADEs), catheter-associated urinary tract infections, central line–associated bloodstream infections, pressure ulcers and surgical site infections, among others. These conditions were selected as focus areas because they occur frequently and appear to be largely preventable based on existing evidence.
ADEs were down by 29% in 2015 compared with 2010. They also accounted for by far the largest share of the estimated 3,097,400 cumulative reduction in HACs between 2011 and 2015, at 42.3%. Pressure ulcers represented 23.2% of the reduction, and catheter-associated urinary tract infections, 15.2%. The primary ADEs assessed were those associated with hypoglycemic agents, IV heparin, low-molecular-weight heparin and factor Xa inhibitor, and warfarin.
Preliminary estimates for 2015 alone indicate that more than 37,000 fewer patients died in hospitals in 2015 as a result of the decline in HACs, compared with the deaths that would have occurred if the rate of HACs had remained constant at 2010 levels.
“Although the precise causes of the decline in patient harm are not fully understood, the increase in safety has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events,” the report noted. “This effort has been spurred in part by Medicare payment incentives and catalyzed by the U.S. Department of Health and Human Services (HHS) Partnership for Patients (PfP) initiative, which was started in 2011.”
“The Affordable Care Act gave us tools to build a better health care system that protects patients, improves quality, and makes the most of our health care dollars, and those tools are generating results,” said HHS Secretary Sylvia Mathews Burwell in a statement. “Today’s report shows us hundreds of thousands of Americans have been spared from deadly hospital acquired conditions, resulting in thousands of lives saved and billions of dollars saved.”
AHRQ developed and tested much of the evidence on how to prevent HACs. For example, one of the tools used most frequently by hospitals is AHRQ’s Comprehensive Unit-based Safety Program (CUSP), which is a proven method that combines improvement in safety culture, teamwork and communications with evidence-based practices to prevent harm and make the care patients receive safer. AHRQ has worked hand in hand with front-line clinicians to help them use CUSP in a series of nationwide projects that have been highly effective in preventing health care–associated infections.