For a study, researchers sought to assess the shift in the frequency of unfavorable occurrences among hospitalized patients.

The Medicare Patient Safety Monitoring System data from 2010 to 2019 were used in the serial cross-sectional analysis to evaluate patient adverse events while in the hospital. Acute myocardial infarction (17%), heart failure (17%), pneumonia (21%), and major surgical procedures (22%) were the 4 condition groups represented by 244,542 adult patients hospitalized in 3,156 US acute care hospitals from 2010 to 2019. Patients hospitalized from 2012 to 2019 for all other conditions were also included in the study (22%). ABout 21 metrics covering 4 adverse event domains—adverse medication events, hospital-acquired infections, adverse events following surgery, and general adverse events (hospital-acquired pressure ulcers and falls)—were included in the adverse event data (extracted from medical records). The results represented the cumulative change over time for the observed and risk-adjusted adverse event rates in the subpopulations.

The study sample consisted of 54,256 hospital discharges for the group, including all other conditions (mean age, 57.7 [SD, 20.7] years; 59.8% were female) and 190,286 hospital discharges for the 4 condition-based groups of acute myocardial infarction, heart failure, pneumonia, and major surgical procedures. These discharges came from 3,156 acute care hospitals across the US. The rate of unfavorable occurrences for all other situations remained constant from 2012 to 2019 at 70 unfavorable events per 1,000 discharges. The annual change represented by relative risk in all adverse events per 1,000 discharges, after adjusting for patient and hospital characteristics, was 0.94 (95% CI, 0.93-0.94) for acute myocardial infarction, 0.95 (95% CI, 0.94-0.96) for heart failure, 0.94 (95% CI, 0.93-0.95) for pneumonia, 0.93 (95% CI, 0.92-0.94) for major surgical procedures, and 0.97 (95% CI, 0.96-0.99) for all other conditions. The risk-adjusted adverse event rates for adverse medication events, hospital-acquired infections, and general adverse events considerably decreased in all patient categories. The risk-adjusted rates of events following a surgery considerably decreased for patients in the group who underwent major surgical operations.

For patients admitted for acute myocardial infarction, heart failure, pneumonia, and major surgical procedures in the US between 2010 and 2019, the rates of adverse events abstracted from medical records significantly decreased. Between 2012 and 2019, the adjusted rates of adverse events for all other conditions also significantly decreased. To fully grasp how much of a shift in patient safety these patterns signify, more study was needed.

Reference: jamanetwork.com/journals/jama/article-abstract/2794055