Monday, May 09, 2016

HEALTH - What is the Leading Cause of Death?

"Is fatal medical error a leading cause of death?" PBS NewsHour 5/4/2016

This article essentially says that the CDC keeps track of  'cause of death' by the codes used by hospitals (health care insurance).  This begs the question, why isn't the CDC they tracking 'cause of death' as stated by coroners?


SUMMARY:  The CDC does not list “medical error” as a cause of death in its annual mortality statistics.  But according to researchers from Johns Hopkins University, medical errors are the third leading cause of death in the nation.  Hari Sreenivasan talks to Dr. Martin Makary of Johns Hopkins, the report’s author, about why medical errors are usually ignored and how patients and doctors can try to avoid them.

HARI SREENIVASAN (NewsHour):  For the better part of two decades, there’s been a growing recognition that medical errors kill too many patients in the U.S.

While exact numbers are elusive, a new analysis and estimate portrays an even grimmer picture.  The new paper finds that as many as 250,000 people die each year from errors in hospitals and other health care facilities.  That would make it the third leading cause of death in the U.S., ahead of respiratory disease, accidents and even stroke.

Dr. Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine who led the research, joins me now.

So, how did we get to this number? What did your research find?

DR. MARTIN MAKARY, Johns Hopkins University School of Medicine:  Well, we took the best available studies, the data from the medical literature, and we basically came up with a meta-analysis point estimate, and then asked, where would that fall if medical error were counted as a disease?

It turns out that we learned that the CDC doesn’t consider medical error to be a cause of death in listing our national health statistics each year, even though the point estimate comes right in between number two and number three on the list, which means medical error is the number three cause of death in the United States.  We’re just not measuring it.

HARI SREENIVASAN:  OK.  So, let’s talk a little bit about the methodology.

If the numbers are scarce, are these studies representative enough sample sets to be able to extrapolate this quarter-million?

DR. MARTIN MAKARY:  These are studies of hundreds of thousands of hospitalizations in the top medical journals.  And they are updating the 1999 Institute of Medicine report.

And there’s broad consensus that the range is somewhere between 200,000 and 400,000.  Our analysis came up with 251,000.  No matter what number you pick, it is well above the currently listed number three cause of death.  And it turns out that the reason it’s not being counted is that the system relies on billing codes to compile our national health statistics.

But people don’t always die of a billing code.  They can die from diagnostic errors, fragmented care, preventable complications.  These are not things that are captured in national health statistics.  That list of most common causes of death in the United States, that list is a big deal.

It informs all of our research funding priorities as a country, all of our public health campaigns.  We spend a lot of time and money on heart disease and cancer, but we haven’t even really recognized that the third leading burden on health in America in terms of death is medical error in its many forms.

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