Metrics for Transformation –
Avoidable Health Care-Related Mortality
Why Measure Health Care-Related Mortality?
In 2011 alone, there were over 200,000 deaths due to failures of the health care systemiii. Compare that number to annual deaths from foodborne illness (~3,000)iv, workplace safety failures (~4,600)v, all modes of transportation (~36,000)vi, and the difference is striking. Compared to other countries, the US has a considerably higher rate of mortality due to failures of the health care system. This excedent in deaths is caused by several factors, as reported in a paper by Nolte and McKee on “Mortality Amenable to Health Carevii”. One factor is a higher rate of mortality from patient safety failures. While the 1999 Institute of Medicine report, “To Err is Human”, created temporary headlines on the issue, not much progress has been made to date in reducing the then reported close to 100,000 deaths. Another factor is the lack of comprehensive care and care coordination that cause many patients with several chronic conditions to die, simply because no clinician is properly overseeing their care. HCI3’s work on Potentially Avoidable Complications highlights the cost of these complications for payers, and the magnitude of the problem in terms of the sheer frequency of these complications in patients with common chronic conditions. A third factor is the continued gaps in preventive care that cause patients to die from diseases that otherwise could be treated. Altogether, the excedent in deaths from health care provides us with a yardstick against which we can measure the overall effectiveness of the US health care system compared to other countries.
What We Are Doing To Impact These Measures
All of HCI3’s activity is focused on making healthcare more affordable and higher quality, and we employ several strategies that are further delineated in the measures that fit underneath each of these top metrics. In addition to our work, it is the responsibility of every American to fight for the changes that are needed to reduce the current financial burden on families caused by health care expenses, and to reduce the gaps in quality that are causing thousands of Americans to die from health care related failures every year. To get involved, read The Incentive Cure.
Measures and Data Sources
- The US rate of mortality amenable to health care per 100,000 (currently 96 per 100,000) and, from that:
- The daily number of deaths in the US due to failures of the health care system. On average, there are 584 deaths per day due to failures of the health care system.
- The year to date number of deaths in the US due to failures of the health care system. As of January 4th 2013, there were 1,751 deaths due to health care system failures.
- The benchmark rate of mortality amenable to health care per 100,000 (currently 55 per 100,000) and, by subtracting the benchmark from the US rate:
- The daily number of deaths in the US in excess of the benchmark due to failures of the health care system. On average, there are 249 deaths per day in excess of the benchmark.
- The year to date number of death in the US in excess of the benchmark due to failures of the health care system. As of January 4th 2013, there were 748 deaths in excess of the benchmark.
The US and benchmark rates of mortality amenable to health care are pulled directly from the Commonwealth Fund’s National Scorecard on US Health System Performance. The daily number of deaths and year to date deaths are extrapolated from the National Scorecard, which reports that the difference between the US rate and the benchmark rate, and currently translates into an additional 91,000 deaths in the US each year.