Research indicates that the country could avoid 36,000 annual deaths with infection prevention and operational failures
A survey by the Feluma Research Institute of the Faculty of Medical Sciences of Minas Gerais, in partnership with the Institute of Supplementary Health Studies (IESS), detected alarming data for health in Brazil: about 150 people die each day, in Brazilian hospitals, due to errors and operational failures, and two-thirds of these deaths could be avoided.
The numbers of the 2nd Annual Hospital Care Security in Brazil refer to 2017 and refer to the so-called “serious adverse events”, which include several factors that prevent the perfect functioning of a hospital, such as errors in medication use, surgical complications, poor use of contraceptive devices and infections.
According to the survey, more than 54,000 deaths were caused in the country by serious adverse events, of which 36,000 were preventable. This represents 150 deaths per day and six per hour, number close to that of violent deaths in the country, from seven to every hour, according to the Brazilian Yearbook of Public Safety of 2016.
According to the researchers, five of these factors do not have any type of prevention program, either in the public or private network: cardiorespiratory arrest, renal insufficiency, pulmonary aspiration, postoperative hemorrhage, and respiratory failure.
“Adverse events are inherent in any health service, even in the best and most sophisticated systems in the world. It is not, therefore, a question of seeking guilty parties, but of proposing measures that address the problem, “says Dr. Renato Couto, one of the people responsible for the survey.
According to Datasus, a database of the Unified Health System, in 2016 Brazil recorded almost 880 thousand deaths in hospitals. Thus, more than 6% of deaths in this environment refer to operational failures and errors.
In the first Yearbook of Hospital Health Care Safety in Brazil, related to 2016 and published in 2017, which was developed with another methodology, the estimate was 300,000 deaths per year for serious adverse events, which makes the current research conservative in relation to the last year.
“The fact that the hospitals analyzed in the study are considered ‘front-line’ and present these numbers indicates that the national average projected from the sample studied is probably underestimating the problem,” says IESS Executive Superintendent Luiz Augusto Carneiro.
The survey was based on samples from more than 450,000 patients hospitalized in public and private hospitals throughout 2017. Data were collected in municipalities with more than 100,000 inhabitants and with development above the national average, distributed throughout the Brazilian territory.
For Carneiro, one of the main reasons for hospital failures is the country’s service delivery model, the “fee-for-service”, in which hospitals are paid according to the work performed.
“We’re a rewarding waste. In the current model, insecure organizations with higher incidences of errors are rewarded with increased revenues because of the work they have done, “he criticizes.
The doctor Renato Couto, in turn, adds: “It is natural that, if the expenses started from a hospital error, the entity itself arises with these additional costs.”
Capacity of service
In addition to the great loss caused by the loss of thousands of lives in the country, the survey also estimated how much service capacity Brazil loses as a result of hospital failures. According to the study, they lead to a longer recovery time of the patients, which favors bed occupancy for longer and prevents more patients from being treated.
According to the research, each serious adverse event increases the patient’s average hospitalization period by 14.4 days, which has hampered the care of 7.7 million people in 2017.