Hospitals are meant to save lives — but they can too often be deadly places to spend time.
From the infections patients get when they stay in the hospital (which kill about 75,000 people annually) to medical mistakes (surgeons left an impressive 4,857 items in patients over the last two decades), hospitals are places where lots can go wrong.
But hospitals are, just slightly, starting to get better at getting things right. A new federal report shows that improvements in hospital care saved 50,000 lives between 2010 and 2013, all by doing better at not making patients sick.
Hospitals are making fewer people sick
The number of patients who had a hospital-acquired condition — anything from an infection of a surgical site or a fall during recovery — fell by 17 percent between 2010 and 2013.
That translates to 1.3 million fewer harmful incidents than if the 2010 rate had held constant and 50,000 fewer patients death.
The declines span all different types of care. Surgical infections fell by 19 percent. Pressure ulcers (which patients often develop spending days lying in bed) declined by 20 percent.
The biggest decline by far was among central-line-related infections, which can happen when bacteria infect a patient through a catheter delivering medication or fluids.
This decline in hospital-acquired conditions has coincided with a similar drop in hospital readmissions: cases where patients come back to the hospital after something was screwed up the first time. Hospital readmissions began to fall in 2012 after holding constant for years, a change that the Obama administration estimates has saved 15,000 lives.
The federal government doesn't have comparable data on hospital acquired conditions prior to 2010, which makes it difficult to compare this current decline with past trends. But taken with the readmissions data, the new information shows that hospitals really are becoming safer places to get treated.
Obama administration claims victory
What explains these declines? The Department of Health and Human Services has largely pointed at a set of programs that have come into effect since 2010 for catalyzing a movement towards better care and more emphasis on patient safety.
Some of them are part of Obamacare: new financial penalties for hospitals that have particularly high rates of readmissions or harm to Medicare patients. Many of those programs began in 2010 and 2011, with the money at stake rising year after year.
Private insurers, meanwhile, have moved in the same direction, tethering their own payments to hospitals to the quality of care that patients receive. One recent report found that 40 percent of private plans' payments to hospitals were in some way contingent on quality in 2014 — a big jump from the 11 percent of incentive-based payments in 2013.
Then there's also the Partnership for Patients, a government project that's part of the Affordable Care Act, aiming to reduce the number of hospital-acquired conditions by 40 percent between 2010 and 2014. That program has enrolled more than 3,700 hospitals — who account for four in every five hospital patients — in a learning collaborative to share best practices for increasing patient safety.
"The increase in safety has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events," the new report argues.