Just the Facts on Health Care
There were 613 people killed by terrorists throughout the world in 2003, but there were up to 100,000 deaths attributed to health care errors in the United States alone that same year.
Which two industries have the biggest opportunity for improvement?
• Travel? No.
• Manufacturing? No.
• Telecommunications? No.
• Banking? No.
• Transportation? No.
• Construction? No.
• Government? Yes.
• Health care? Yes.
It seems that the U.S. public cares less about the number of people killed due to medical errors than it does about other industries' errors. Just look at the amount of attention that Firestone and Ford got when Firestone's manufacturing process produced some defective tires that caused a few dozen fatal car accidents. The problem was highlighted on television and in newspapers, and the government was about to step in. It was the talk of the town, and as a result of this bad publicity, Firestone's stock fell. However, in terms of errors made by product or service providers, you're safer driving in your car than lying in the hospital.
No other industry is more in need of reinventing itself than health care. Consider some of the following facts:
• It's estimated that between 1.5 to 2.2 million people around the world die as a result of health care errors every year. That number would be even higher, except a large percentage of the world's population isn't exposed to modern health care.
• Every eight minutes, someone in the United States dies as a result of nosocomial infection; 95 percent of these cases are preventable.
• Hospitals that foster an atmosphere of distrust have a death rate 58 percent higher than average.
• Two million patients per year in the United States acquire an infection while hospitalized for other conditions, and 88,000 die as a direct or indirect result. This adds an additional $5 billion to health care costs.
• In the United States, health care accounts for 15 percent of the GNP. This compares to 8 percent to 10 percent in Japan, Europe and Canada.
• Health insurance premiums rose an average of 14 percent in 2003 and are projected to rise by 11 percent to 20 percent annually for the next three years.
• U.S. health care spending is $1.7 trillion.
• Forty-three million people in the United States are without any medical insurance.
• Seventy-seven million people will be retiring soon with reduced health care benefits, which will put more strain on the already shaky medical system.
• U.S. health care consumers pay the highest prices in the world for drugs, therapists, and diagnostic and treatment technologies, effectively subsidizing health care research, development and treatment in other industrialized nations as well as developing countries.
• Studies have demonstrated that geographic location strongly determines specialty care access and procedural decision making.
• Few health care entities are registered to ISO 9001.
• Performance metrics are virtually nonexistent in the health care industry.
• Health care costs are contributing to the offshore movement of goods and services because medical overhead is lower in other countries.
• Thirty percent to 40 percent of health care cost waste is caused by errors made by specialists.
• The United States is the only developed nation whose health care isn't run by the government.
• There's little standardization in treating patients.
• Total quality management and continuous quality improvement are poorly implemented in most health care organizations.
• Information technology can save $140 billion per year by improving patient care and eliminating redundant tests.
• Two percent of hospital patients experience an adverse drug reaction, resulting in increased lengths of stay and an average of $4,700 in added expenses.
• The health care error rate is about 6,210 errors per million opportunities (3.8 sigma), and some treatment activities run as high as one sigma.
• One in 11 babies born vaginally suffers injury.
• One out of 1,124 hospitalized seniors can expect to fracture a hip.
• Adverse events occur in 7.5 percent of medical or surgical admissions, 37 percent of which are preventable.
I believe that we need an ISO-type standard for quality in health care. What do you think? I'll give you some more data on the health care problem next month.
H. James Harrington is CEO of the Harrington Institute Inc. and chairman of the board of Harrington Group. He has more than 55 years of experience as a quality professional and is the author of 22 books. Visit his Web site at www.harrington-institute.com.
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