Australian research looks at hospital acquired medical complications

By Dr. Ananya Mandal, MDFeb 6 2018

Dr Ananya Mandal, MD

A new study has shown that one in nine Australian patients who were hospitalized between 2012 and 2015, suffered from one or the other hospital acquired complication. These complications are usually of a preventable nature and occur when there is a deficiency in patient care.

This could be a hospital acquired infection or medication errors, pressure or bed sores, malnutrition and even a breach in hygiene protocols finds the study. The report released from Grattan Institute is titled, “All complications should count: Using our data to make hospitals safer,” and looks into comparative hospital performance in terms of complications associated with healthcare.

The report looked at the hospital acquired complications that are preventable but may occur on hospital admissions in a large number of patients. It shows that there is a wide variation (2.9 percent to 16.6 percent) in terms of risk of these complications in these hospitals and patients need to be aware of these preventable complications to reduce morbidity. This report aims to improve the safety of care in the hospitals. They authors write that the risk of complications on the same day of admission is low at around 3 percent of all admissions. However for every four patients who stays at the hospital for a night, one gets a complication associated with hospital stay, they note.

They do not identify the hospitals that have higher rates of complications and those that have low rates of complications in their report but mention that the rates are varied. The team for example looked at knee replacement procedures at three hospitals and mapped out the rates of complications associated with the operation and hospital stay. While one hospital shows lower rates of complications, it could be because they care better for the elderly patients than the other two, they write.

Authors of the report emphasize the importance of this report saying that there are differences in rates of complications among hospitals but there is no ready reference such as these for the Australian hospitals. They mention the importance of improving patient care, reducing pain and health risks for the patients as well as reducing health care costs, insurance premiums and hospital stays for patients that occur if there are complications.

The authors write that all patients should be aware of their risks and the risks should be stratified according to age, gender, health conditions, other diseases etc. Most patients are not aware of the risks they might face on hospital admission, the authors write. While some of these complications may be simple and curable easily, yet others may be life threatening. Grattan Institute Health Program Director Stephen Duckett said that these were the “best kept secrets” from the public as well as from hospitals and doctors themselves and this needs to change.

The authors of the report urge state governments and private health insurers to understand and share this information with the general public to increase awareness. Recent updated information regarding comparative performance of the hospitals should be available. They say that if the hospitals are not aware of their problems and compare themselves with their peers, they are less likely to work on their problem areas and improve them.

Some of the advisories that the report sends out to hospitals include four simple recommendations;

• Establishment of goals to reduce complication rates in public and private hospitals in all states and territories
• Hospitals and clinicians of all states and territories need to be able to look at all patient performances everywhere in order to compare. Strategies for improvement can be devised from these observations.
• All states and territories should publish the information regarding complications from the hospitals under their umbrella. This includes both public and private hospitals.

Health insurers should provide the members with the comparative information regarding the complication rates of the hospitals.

Source: https://grattan.edu.au/report/all-complications-should-count-using-our-data-to-make-hospitals-safer/