ParfumGigi@aol.com
19 mars, 2008 21:02
Making Hospitals Pay For Own Mistakes
PHILADELPHIA, March 17, 2008
(CBS) William Doyle survived his open-heart surgery - but was almost killed, days later, by a hospital mistake, CBS News correspondent Wyatt Andrews reports.
"At the time, I very easily could have died from this infection," Doyle said.
It was a chest infection, caused by a breakdown in hospital cleanliness. After a second operation and months of extra care, the bill to treat his infection was almost double the charge for his surgery.
As Doyle noted, the complication was more expensive than original problem.
What to do about big, expensive hospital mistakes is a question about to be answered in a revolutionary way. Both the Medicare system and several large insurance companies have said they won't pay hospitals any more for certain preventable errors.
Beginning in October, Medicare will no longer pay for eight hospital mistakes - including:
Urinary infection from catheter
Bed sores
Surgical object left in body
Air embolism
Giving wrong type of blood
Blood infection from catheter
Chest infection after bypass surgery
Hospital-caused injury
"We think it's a big deal," said Kerry Weems, Medicare's acting administrator. He says when the system stops paying for preventable mistakes, hospitals will stop making them.
"And that's what this is really about, avoiding errors and improving the quality of care for everybody," he said.
One state, Pennsylvania, is already refusing to pay for errors.
It's Medicaid program lists 27 mistakes called "never events," including "surgery done on the wrong body part" and medication leading to injury or death.
Medication error is what almost killed the twins born to actor Dennis Quaid and his wife Kimberly. They told 60 Minutes correspondent Steve Kroft how the twins got massive overdoses of the blood thinner heparin.
Read Steve Kroft's full 60 Minutes report.
And "never event," said Governor Ed Rendell, means the state will never pay.
"Its not just about constraining costs, its about saving lives," he said. "Preventable medical errors cause more deaths in this country than Alzheimer's, diabetes, almost to the level of stroke. That's stunning, isn't it?"
Already some innovative hospitals are working to eliminate mistakes. Before every bypass surgery, surgeons in the Geisinger Health System in Pennsylvania use a 40-step safety list.
And if there is any error, the hospital pays. No added expense are charged to the patient or insurance company. It's like a warranty, and after two years, they say it's working.
"We've had fewer complications, fewer mortalities, generally all these clinical outcomes are moving in the right direction," Dr. Ronald Paulus of the Geisinger Health System said.
For decades, the U.S. health care system has paid doctors and hospitals by the services performed, even if those services harmed the patient.
To many experts the real question is: Why did it take so long to stop paying for preventable mistakes?
