Inadequate Coding Means Medical Error-Related Deaths Are Underreported, Study Says
A high-profile new study, published in the British Medical Journal, suggests that medical errors are the third leading cause of death in the United States—but that it is not listed as such because of the way cause of death is coded and reported.
Investigators from Johns Hopkins believe, according to an analysis of prior research, that over 250,000 Americans die from medical errors annually. This ranks just below heart disease and cancer, which experts say cost 600,000 lives each in 2014.
Johns Hopkins researchers defined death due to medical errors as:
- An error in judgment, skill, or coordination of care
- A diagnostic error
- A system defect resulting in death or failure to rescue a patient from death
- A preventable adverse event
In a letter to the Centers for Disease Control and Prevention, the researchers implored the agency to change its annual cause of death rankings to include medical errors, and suggest that medical errors aren’t on the list due to the limitations of coding practices. They say that the CDC’s published mortality statistics give only the “underlying cause of death,” which is defined as the condition that led an individual to get treatment, according to their study.
In their letter to the CDC, the study authors note: “Since 1949… the CDC has tabulated the national mortality statistics by assigning an International Classification of Disease (ICD) billing code to the cause of death. As a result, causes of death not associated with an ICD code, such as human and system factors in medical care, are not captured.”
They go on to assert that the CDC should allow clinicians to list medical errors as cause of death.
The CDC’s Bob Anderson, chief of the mortality statistics branch of the agency, argues that there already are adequate means for recording and reporting medical errors on death certificates, according to an interview with National Public Radio. Additionally, he adds that asking physicians to check a box noting that they’ve made an error could be “uncomfortable.”
But Dr. Eric Thomas, a professor of medicine at the University of Texas Houston Medical School, tells NPR that he agrees medical errors are underreported and that efforts to collect better data should be explored.
“If we can clarify for the public and lawmakers how big a problem these errors are, you would hope it would lead to more resources toward patient safety,” Thomas told NPR.