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Related Experiment Videos

Structural codes and patient safety: does strict compliance make sense?

R Feeley, D C Walsh, J E Fielding

    American Journal of Law & Medicine
    |January 1, 1977
    PubMed
    Summary

    Strict enforcement of healthcare facility safety codes is costly, potentially costing millions per life-year saved. This expense may outweigh benefits compared to other health interventions, suggesting budget reallocation for better patient outcomes.

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    Area of Science:

    • Health Policy and Economics
    • Healthcare Administration
    • Public Health

    Background:

    • Increasingly stringent enforcement of building and safety codes in healthcare facilities is a notable trend.
    • These regulations aim to enhance patient safety and facility compliance.
    • The economic implications and comparative effectiveness of these safety measures warrant critical evaluation.

    Purpose of the Study:

    • To compare the financial costs of rigid enforcement of healthcare facility safety codes with their projected benefits in terms of life-years saved.
    • To contextualize these costs against other established, expensive medical technologies.
    • To explore the potential for reallocating healthcare resources for greater patient benefit.

    Main Methods:

    • Cost-benefit analysis comparing estimated expenditures for code enforcement against potential life-years gained.

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  • Estimation of costs per potential life-year saved for hospitals and nursing homes under strict Life Safety Code enforcement.
  • Comparative analysis with the cost-effectiveness of kidney dialysis as a benchmark.

    • Main Results:

    • Strict enforcement of the Life Safety Code (LSC) is estimated to cost between $12.7-$63.5 million per potential life-year saved in hospitals.
    • For nursing homes, the cost is estimated at $1.1-$2.6 million per potential life-year saved, based on Massachusetts data.
    • These costs are significantly higher than that of kidney dialysis, approximately $20,000 per life-year saved.

    Conclusions:

    • The substantial financial resources dedicated to strict adherence to safety codes may not be the most effective allocation of limited healthcare budgets.
    • Even with full effectiveness, the current structure of the LSC may yield questionable returns on investment.
    • Reallocating a portion of these funds to other patient-focused activities could offer greater improvements in the quality of life for hospital and nursing home patients.