The commonest cause of death and disability in the world is cardiovascular disease, closely followed by cancer. Coming in at number three and closing in fast is Western health care. It is estimated that in the US alone there are 780,000 deaths on a yearly basis as a consequence of doctors treating patients.
A preventative health expert from the United Kingdom has recently suggested that 10% of hospital admissions are directly due to medical error. A recently released report from the Grattan Institute has basically assessed the complication rate for Australian hospitals. It appears that one in nine patients being treated in an Australian hospital will suffer a complication and this increases to 1 in 4 if the person is lucky enough to be admitted overnight. Interestingly, however, this review did show that some hospitals have a complication rate of a whopping 16.6% whilst others only 2.9%. This raises the question-if some institutions are so low why aren’t all witnessing complications at the same rate? It is not clear from the report if it is that the institutions with the highest rate are purely treating the sickest of the sick i.e. people at greater risk, or whether the higher complication institutions do not have the same rigid safety protocols, high-quality or less constant staff.
These complications range from anything between the catastrophic and very rare situations e.g. the two babies who were accidentally gassed with nitrous oxide leading to their tragic death at the Bankstown-Lidcome Hospital.
Complications may also involve healthy patients contracting infections after surgery. The federal government has published a list of 16 relatively common hospital acquired complications which in many cases may be prevented. To give some examples, these include pressure injuries leading to skin ulceration; unsupervised falls within the institution leading to either fractures or head injury; the very common infections which can be anything from hospital-acquired urinary tract infection to infections complicating surgery; other surgical complications requiring return to the theatre such as haemorrhage or wounded dehiscence, to name a few.
As I am suggesting, these complications can vary from minor wound infections or modest reactions to prescribed medications to the more life-threatening severe infections, bleeding, clotting or kidney failure.
In defence of my hospital colleagues, the reality is that the more serious complications typically occur in the sickest of the sick who would possibly die without medical intervention and it is hardly fair to blame the hospital, medical nursing staff for that person’s complications. But, often healthy people undergoing elective procedures may develop serious complications. Some examples here are a person who goes for a routine colonoscopy experiencing a bowel perforation. Another example is the person who has been sent for a radiologic procedure involving intravenous dye developing a serious, life-threatening anaphylactic reaction to the dye.
The reality is that strong medicine has strong effects but also strong side-effects and complications. The more aggressive the therapy, often the greater the benefit but also the greater risk.
Regardless, the current figures are unacceptable, especially where there is such variation between institutions and we do need better explanations and solutions than this report is offering. Hospital care is an essential component of modern society but those who avail themselves in this care need to know that hospitals are safe places.