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Vrijdag 18 mei 2012         SIN-NL risicoanalyse en management ten bate van slachtoffers van medische fouten

Links Archief Meldpunt Contact

Geen zorgtaks: laat artsen zelf de kosten van medische fouten betalen, 26 sept. 2007.

Aan de redactie van NRC Handelsblad, 26 september 2007

Geachte Heer/Mevrouw,

Hierbij verzoek ik U onderstaande reactie in Uw krant te plaatsen.

De oproep van Pieter Vierhout, Orde van Medisch Specialisten en Lans Bovenberg, Universiteit van Tilburg, in NRC 25 sept. 2007 om een zorgtaks in te stellen op ongezonde levensstijl is ongenuanceerd en een duidelijke poging om de media-aandacht af te wenden van de falende gezondheidszorg.
Immers uit het Nivel/Emgo rapport april 2007 blijkt dat de kosten van medische fouten in ziekenhuizen minimaal 167 miljoen euro per jaar, ca 1.1 procent van het budget voor ziekenhuizen in 2004 zijn, zie pagina 63 van het rapport.
Daar Jan Vesseur hoofdinspecteur Inspectie Gezondheidszorg en lid van de begeleidingscommissie van dit rapport op 8 mei 2007 tijdens een congres in het openbaar zei dat het aantal slachtoffers minimaal twee keer zo hoog was, zijn de kosten dus ook minimaal twee keer zo hoog, ca 340 miljoen euro per jaar.
Over medische fouten door huisartsen is niets bekend, laat staan de kosten.
In dit kader is de recent aangekondigde verhoging van de zorgpremie ook volkomen onterecht.
Zelfs als je gezond leeft, kun je ziek worden. Dan kom je terecht in een ziekenhuis dat niet veilig is, zoals Nico Oudendijk plv Inspecteur Generaal van de Inspectie Gezondheidszorg augustus 2006 in de NRC duidelijk zei.
Wie is verantwoordelijk voor deze situatie? Niet de gezondlevende patiënt, maar de artsen en de ziekenhuizen en de Inspectie.
Verander allereerst het systeem dat iedere vorm van gezondheidszorg, ook de slechte prestaties, gewoon betaald worden, zie artikel Boston Globe 12 september 2007 hieronder. Slechte prestaties horen niet beloond te worden, integendeel. De veroorzaker, dus de arts hoort te betalen!
Verlaag in dit kader ook de topsalarissen en gouden handdrukken van bestuurders in de gezondheidszorg.
Voer registratie en onderzoek in naar medische fouten en : doe aan preventie.
Zo voorkom je te hoge en onnodige kosten in de gezondheidszorg.
Leef uiteraard gezond en denk na indien je toch het advies van een arts moet vragen.
Uiteraard ben ik tot nadere toelichting bereid, met vriendelijke groet,

Sophie Hankes
Voorzitter Iatrogenic Unite-Alliance www.ieu-alliance.eu
Voorzitter Slachtoffers Iatrogene Nalatigheid-Nederland www.sin-nl.org


Richard Lord and Dr. Marylou Buyse

We pay for medical errors September 12, 2007 Boston Globe

WHAT IF your mechanic forgot to replace the lug nuts after changing one of your tires and you got into a serious accident when the wheel came off? You wouldn't expect your mechanic to send you a bill for the repairs, would you?

Unfortunately, that's what happens in healthcare and we pay a high price for mistakes.

Eight years have passed since the Institute of Medicine's landmark study, "To Err is Human," which found that as many as 98,000 patients die each year in America's hospitals as a result of medication overdoses, postsurgical infections, and other medical errors. These are preventable deaths, yet medical mistakes cause more deaths than car accidents, breast cancer, or AIDS.

Even when mistakes are not fatal, they can still have devastating results. They can lead to injury, disability, extended hospital stays, or lengthy recoveries. And we often pay twice when errors occur - once for the mistake and again to correct it. Nationally, the cost of preventable medical errors, lost income, and lost productivity is estimated at $17 billion to $29 billion a year.

Employers bear a large part of that expense. In Massachusetts, more than four out of every five insured individuals under the age of 65 receive coverage through an employer. So when preventable errors occur, it is businesses that pay.

Take, for example, routine bypass surgery, which can cost more than $50,000. When a sponge or a surgical instrument is left inside the patient, correcting the mistake can add tens of thousands of dollars to the cost of caring for that individual. These errors should never happen, but are far too frequent and, ultimately, employers are left paying the bill through higher health and disability premiums.

Medical care in Massachusetts is the most expensive in the country - $7,075 per resident is spent every year, compared with the national average of $5,313. Healthcare costs are increasing three times faster than the annual rate of inflation, and the quality of care can vary between and among healthcare facilities.

On many measures, Massachusetts healthcare providers and medical institutions are the envy of the world, but we can do more to improve the quality of care in the state. We can start by raising the bar higher, through public reporting of medical errors and by removing the financial benefit when serious mistakes occur.

Legislation to require public reporting of medical errors that will be heard by the Legislature's Public Health Committee today is a good place to start, and many in the healthcare system have been working to make that information available. Still, we can go farther. The legislation should be revised so that providers are not allowed to bill for the extra costs of treating preventable errors, injuries, and infections that occur in hospitals.

Healthcare entities should not be rewarded financially when such preventable errors occur. Hospital-acquired infections offer one example. An August 2007 report by the state's Betsy Lehman Center for Patient Safety and Medical Error Reduction found that infections contracted during a hospital stay could be causing up to $473 million in medical costs annually in Massachusetts. Meanwhile, there are hospitals around the nation that have driven their infection rates down to zero.

Prohibiting billing for so-called "never events" is another example. These are rare but serious medical errors that should never happen to a patient, such as conducting surgery on the wrong body part, leaving a foreign object in a patient after surgery, or patient death or serious injury resulting from a medication error.

While healthcare facilities currently are required to report major medical incidents to the state, these reports are not readily available or useful to the public. In 2005, the state's Board of Registration in Medicine issued a report that found that healthcare facilities reported 24 never events the prior year, but did not identify the institutions, leaving both patients and the healthcare system unaware where these mistakes occur. We need stronger measures in place to prevent these errors from continuing to happen.

No other industry generates revenue from mistakes. Preventable errors should not be part of the usual cost of healthcare.

Richard Lord is president and CEO of Associated Industries of Massachusetts. Dr. Marylou Buyse is a practicing primary care physician and president of the Massachusetts Association of Health Plans.

© Copyright 2007 Globe Newspaper Company

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