This paper serves as a continuation of the ongoing exploration of a case study regarding issues that may occur within a hospital and their potential effects. In this case, the hospital in question is the University of New Mexico Hospital. This particular paper focuses on the financial issues of the identified problem, which in this case is medical errors.
Keywords: University of New Mexico Hospital, medical errors, financial aspects, financial implications
Medical errors are mistakes that occur during the course of healthcare delivery that have the potential to, but do not always, injure the patient (Improving Medication Safety, 2012). Medical errors can occur at any time, during any level of care being received by the patient. These medical errors come at a high cost, in terms of not only the quality of healthcare, but also in the form of the costs to the patient, the healthcare office or offices, and the individual doctors and nurses themselves (Iahue, Pyenson, Iwasaki, Blumen, Forray, & Rothschild, 2013; Weingarten, 2013). While not all costs are financial, it is the financial costs that are focused on at this time.
Changes occurred within the realm of medical billing in 2008 that brought about a host of additional changes to the field of healthcare; in addition to the usual modifications to cost of services, the Center for Medicare and Medicaid Services (CMS) set forth regulations concerning the denial of payments as well, in an effort to work to reduce preventable medical errors (Weingarten, 2013). These changes included denying payments for conditions received in hospitals that were preventable, including falls and pressure ulcers, and the denial of payment for medical errors that were deemed to be preventable, along with the denial of payment for the associated costs of correcting those errors (Weingarten, 2013). These changes were meant to ensure that those who were providing care to patients would take additional cautions, as not only could potential medical error spark a lawsuit and raise malpractice insurance costs for the facility, they would also deny the facility the funds that it would have otherwise received while at the same time making the facility pay for the costs of correcting their error (Weingarten, 2013). In spite of such changes, medical error still persists, and to a high degree. The cost of such errors is even higher.
Statistics show that the cost in 2013 for medication errors in injectable medications alone were $2.7 billion dollars, roughly $600,000 in extra costs from the previous year per hospital (Iahue et al., 2013). Liability claims stemming from medication errors in injectable medications range from “$300 million to $610 million annually, with an average cost of $72,000 per U.S. hospital” (Iahue et al., 2013, p. 413). This does not begin to include the costs associated with lawsuits, settlements, medication errors of non-injectable medications, or other medical errors that may occur within hospitals, nor does it touch on injectable medication errors stemming from pharmacy error or physician’s or PA office injectable medication errors.
While statistics are not yet available for the totality of medical error costs for 2015, or even 2014, statistics show that the 2014 cost for medication error, per error, was $91.6 (Pan, Mays, Kane-Gill, Albert, Patel, Stephens, Rocha-Cunha, & Pulgar, 2015). Statistics are still incomplete for 2013 and 2012 at this time, though as of 2012 it was estimated that “more than 7 million serious, potentially avoidable medication errors occur annually,” and as of 1999, “~44,000-98,000 patients die in the hospital annually due to medical error and 7,000 are attributable to medication errors” (Pan et al., 2015, p. 1). Due to the enormity of the matter, and the fact that hospitals are not required to publish the costs associated with medial errors or the total number of medical errors that occur in their hospital per year, the true enormity of the situation may never be fully identified. It is certain, however, that the cost of medical error is great, and that in depth studies, with access to more information than is required by law, will be necessary to determine the true extent of the costs associated with medical error.
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- Improving Medication Safety. (2012). Obstetrics & Gynecology, 120(2), 406-410.
- Pan, J., Mays, R., Kane-Gill, S., Albert, N., Patel, D., & Stephens, J. et al. (2015). Published Costs of Medication Errors Leading to Preventable Adverse Drug Events in US Hospitals (pp. 1-1). Philadelphia: ISPOR. Retrieved from http://www.ispor.org/research_pdfs/49/pdffiles/PHP73.pdf
- Weingarten, R. M. (2013). Preventable Medical Errors: What’s the Cost? Pennsylvania Nurse, 68(2), 4-10 7p.