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How many deaths are due to medical error? Getting the number right
1Dartmouth Medical School, Hanover, NH, USA. harold.c.sox@dartmouth.edu
Effective Clinical Practice : ECP
|January 11, 2001
Summary
The Institute of Medicine's (IOM) medical error death estimates lack strong evidence. Further review revealed the IOM's figures for preventable deaths are not well-substantiated by cited studies.
Area of Science:
- Medical Quality and Safety
- Health Policy Research
- Patient Outcomes Analysis
Background:
- The Institute of Medicine (IOM) report on medical errors estimated 44,000-98,000 annual deaths in US hospitals due to preventable errors.
- This estimate generated significant public and policy interest.
Purpose of the Study:
- To critically evaluate the documentation and validity of the IOM's estimates on medical error-related deaths.
- To assess the scientific rigor supporting the IOM's conclusions on preventable medical errors.
Main Methods:
- A systematic review of studies cited in the IOM report.
- Analysis of related published literature to corroborate IOM findings.
Main Results:
- Cited studies support the incidence rate of adverse events (2.9%-3.7% of admissions).
- Data supporting the preventability of these events and the specific number of deaths (44,000-98,000) were found to be poorly substantiated.
- Methods for estimating preventable deaths were subjective, with unknown reliability and reproducibility.
Conclusions:
- The IOM's reported numbers of deaths from medical errors could not be confirmed through published literature.
- The lack of robust substantiation for the IOM's influential estimates is a significant concern for policy development.
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