Medicare chief urges push to make hospitals safer

Initial projects focus on helping primary care physicians better coordinate care across multiple health providers, countering today’s fragmented care that too often leaves one doctor not knowing what tests or treatments someone received or missed elsewhere.

One project will work with doctors in eight states — Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan, and Minnesota. A second will offer similar integrated care in hundreds of low-income health clinics around the country.

Better primary care can reduce the chances that people end up in the hospital, said Berwick, the head of the Centers for Medicare and Medicaid Services.

That hospitals are dangerous places, rife with infection and opportunities for errors, is not a new critique. The Institute of Medicine a decade ago warned that up to 98,000 people a year die from medical mistakes.

The new HHS report analyzed the records of 780 Medicare patients hospitalized in October 2008 to examine mistakes and unavoidable consequences of treatment, such as previously unknown drug allergies.

During that month, 134,000 Medicare patients suffered an adverse event while hospitalized, 44 percent of which were preventable, the report concluded.

Late 2008 was when Medicare launched a major program to reduce hospital-caused complications by refusing to pay hospitals for extra treatment required for patients who suffered any of a list of preventable harms. The new report may provide a baseline to measure those efforts.