References and statistics

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  • Estimated percent of residents involved in acts of violence (mostly linked to dementia) against other nursing home residents, in one USA study 2%
  • Estimated percent of elderly people subject to some form of elder abuse – from stealing property to physical assaults. 10%
  • Approximately what percent of elderly people have been assessed as taking medications that are not clinically necessary? 50%
  • What percent of medication administration errors (nursing duties related) using hospital stock (not patients own drugs) were found to occur? 15%
  • In a study of elderly hospital patients (mean age 80 years) what percent were found to be prescribed inappropriate medications? 55%
  • Approximately what percent of medications for chronic disease are not being taken as prescribed? 50%

Inaccurate Medical Records

 

Most Australian GP clinics aren’t using e-health records – 6th April 2016
Why aren’t more people using the My Health Records? – 24th March 2017
One in ten Discharge Summaries get Diagnosis Wrong – 6 minutes
Discharge summaries get diagnosis wrong
– Sydney Morning Herald 2013
Types of Medical Errors Commonly Reported by Family Physicians – Robert Graham Centre February 15th 2002
Assessing explicit error reporting in the narrative electronic medical record using keyword searching – Journal of Biomedical Informatics February – April 2003
Incidence of Adverse Events and Negligence in Hospitalized Patients — Results of the Harvard Medical Practice Study I – NEJM February 7th 1991
The hazards of hospitalization – BMJ Quality & Safety February 1st 2003
The Nature of Adverse Events in Hospitalized Patients — Results of the Harvard Medical Practice Study II – NEJM February 7th 1991
Electronically Screening Discharge Summaries for Adverse Medical Events – Journal of American Medical Informatics Association – July – August 2003
Medication errors and adverse drug events in pediatric inpatients – JAMA 25th April 2001
Error in Medicine – JAMA 21st December 1994
The frequency and nature of medical error in primary care: understanding the diversity across studies – Family Practice 1st June 2003

  • In one study of an Australian hospital, what percent of the discharge summaries were missing significant clinical information? 50%
  • What percent of hospital discharge summaries were found to have an incorrect diagnosis in the same study? 10%
  • What percent of Australians aged 65 and over have registered for a government electronic health records system? (as of April 2018) 14%

Excessive costs

 

Cutting a better drug deal -Stephen Duckett – The Gratten Institute – 5th March 2017
MEDI-VALUE: Health Insurance and Service Innovation in Australia — Implications for the Future of Medicare – Jeremy Sammut – April 2016
Health System needs Broader Focus – Financial Review
Trimming the fat: how we could save billions in the health system – Sydney Morning Herald February 12th 2016
Prostate cancer patients anger at paying huge bills despite health insurance – news.com
Australians pay more for healthcare than France, UK – ABC
Consumers Health Forum slams GP fee proposal – Sydney Morning Herald
Health Spending – patients baring higher costs – Flag Post
Cancer patient Tracy Ryan’s $60,000 bill
Cancer treatment in the Private sector – Norman Swan report
Corporate Health Care site by Michael Wynne
Elisabeth Rosenthal – New York Times – series on excessive costs, over charging and over servicing in USA hospitals
How waste is directly harmful to Patients – Kevin MD
The American Health Care Paradox – USA
Why 5% of patients create 50% of cost – Michael Bell, Forbes 2013
Medical Expenditures during the Last Year of Life: Findings from the 1992–1996 Medicare Current Beneficiary Survey
The American Health Care Paradox – Amazon – Elizabeth Bradley
Spending more and getting less for health care – New York Times – Pauline Chen MD
Australians paying 14 times more for prescription drugs – ABC News
Annual US healthcare spending hits 3.8 trillion – Forbes – Dan Mungo
This map of global health care prices shows Americans are getting ripped off – VOX – Matthew Yglesias
By the numbers, how much did Canada spend on health care in  2013? Carmen Chai – Global News
Tough choices: how to rein in Australia’s rising health bill – The Conversation – Stephen Duckett, Cassie McGannon
High Prices – The New Yorker – Malcolm Gladwell
Pharmacy industry gets fat on high profits – BBC – Richard Anderson
8 facts that explain what’s wrong with American health care – PNHP – Sarah Kliff
Explainer: evergreening and how big pharma keeps prices high – The Conversation – Hazel Moir and Deborah Gleeson
An MRI costs $1,145 in America and $138 in Switzerland. But Medicare could change that – Vox – Ezra Klein
21 graphs that show that America’s health care prices are ludicrous – The Washington Post – Ezra Klein
America’s Bitter Pill – Amazon – Steven Brill
Wasted – Four Corners – ABC – Norman Swan

 

  • Estimated percent of the health budget that could be saved if the Australian Government just stopped paying higher prices for the same procedures, across different hospitals? 0.7%
  • Estimated percent of government spending that actually goes on paying bureaucrates to administer government programs across Australia? 14%
  • Estimated percent of the total health budget in Australia estimated to be wasted on unnecessary tests and treatments? 33%
  • What percent of medical procedures, do an international group of leading doctors and academics now believe is being done unnecessarily? 33%
  • What percent of gravely ill patients in one Canadian hospital were found to be documented to receive CPR, even though they didn’t want it? 33%
  • What is the lower estimate of Americans receiving spinal surgery for back pain, that did not stop their pain or improve their lifestyle? 20%
  • Levels of very high psychological distress experienced by Australian Doctors under the age of 30 5.9%
  • Levels of very high psychological distress experienced by the general Australian population, under the age of 30 2.5%
  • What percent of junior American Doctors revealed that they had been bullied at work? 56%
  • Historically, what is the average diagnosis error rate among radiologists? 30%
  • How accurate is one major USA Medical Schools deep learning system, in detecting breast cancer? 97%
  • What percent of men diagnosed with localized prostate cancer, later regretted the decisions they made regarding treatment? 15%
  • Approximately what percent of patients discharged from Intensive Care Units go on to experience Post Traumatic Stress Disorder? 25%
  • What percent of medical care is now administered in hospital Emergency Departments? 50%
  • What percent of all Australian hospital patients are currently in an Intensive Care bed? 12%
  • What percent of elderly Australians say they would rather die at home? 70%
  • What percent actually do die peacefully, in their own home? 10%
  • What percent of Americans now spend their final days in an Intensive Care Unit? 18%

Problems with Primary Care Services

 

Primary Care’s Image Problem – New York Times November 12th 2009
Top Five Challenges Facing Doctors Right Now – Rendia April 21st 2016

 

  • What percent of people who have undergone coronary bypass surgery go through cardiac rehabilitation? 31%
  • What percent of high waist circumference has been shown to increase risk of death, compared to people with a normal waist circumference? 35%
  • What percent of people with coronary artery disease were found to have improved outcomes after having treatment of periodontal (gum) disease? 40.9%
  • What percent of out-of-pocket health costs in the USA are for alternative health products like herbs? 9.2%

The impact of illegal drugs and alcohol abuse on health services

 

Drug Related Admissions to Intensive Care: The Role of Illicit Drugs and Self Poisoning – Critical Care and Resuscitation 2003
The association between hospital admission and substance use among trauma patients –  Journal of substance use Volume 23, 2018

 

  • What percent of patients in a UK Intensive Care Unit had illegal drug use as an underlying cause of admission? 6%
  • What percent of the yearly Intensive Care Unit budget did these patients consume? 10%
  • What percent of homeless people are estimated to have a mental illness? 25%
  • What percent of the prison population is estimated to have a mental illness? 55%
  • What percent of patients in Emergency Departments are estimated to have a mental illness? 10%

Diagnosis errors

 

Grieving family campaigning to stop preventable type 1 diabetes deaths – June 2017 Diabetes.co.uk

  • Percent of children who are not diagnosed with type 1 diabetes until they have a life threatening episode of diabetic ketoacidosis 20%
  • What are the estimated percent of diagnostic errors in medicine including missed, incorrect, or delayed diagnoses? 10%

Health industry errors

 

The Incident and Cost of Adverse Events in Victorian Hospitals 2004 – 2004 Medical Journal Australia
CareTrack – Assessing the appropriateness of Health Care in Australia – MJA
Health Complain Commissions – Time for a National Approach to Data Collection
Quality and Accreditation in Health Care Services – World Health Organisation
Adverse Drug Events and Medication Errors in Australia – International Journal for Quality in Healthcare
Identification of Doctors at Risk of Recurrent Complaints – British Medical Journal
The Quality in Australian Healthcare Study – PubMed
Medication Errors – Prevention using Information Technology Systems – BJCP
Medication adherence: WHO cares – PubMed Central
Health Insurers say some private hospitals offer costly and  sub-standard care – news.com
Medical Mistakes – a silent Epidemic in Australian Hospitals – ABC
Heart Attack Treatment depends on where you are – The Age
Lack of data create concern over true extent of Medical Errors – ABC
Public Hospital Boards Struggle with Patient Care and Safety – The Age
Australian Health System as bad as US on some Indicators – Sydney Morning Herald
GP referral letters for T2 patients full of Errors 6 minutes
National Road Toll 2013 ABC
The hand that holds the scalpel
Former Bundaberg-based doctor sentenced
Anaesthetist jailed for infecting patients with hepatitis C – ABC 2013
Bureaucrats weigh on health as as number of administrators blows out – The Australian 2016
One in twenty hospital deaths preventable – NHS choices
Berwick Review into Patient Safety – UK

Variation in Stroke Services Shock MP’s – The Independent
International Study – US leads in Medical Errors
Anatomy of a Tragedy – Texas Observer
How many die from Medical Mistakes in the USA? – ProPublica
When Healthcare makes you Sick – USA today
Six Frightening Facts you need to know about Healthcare – Forbes
Op-Ed The Culture of Healthcare Secrecy Harms Patients – Seattle Times
Count the Dead from Medical Harm – Huffington Post
Preventing Errors in Healthcare – A call to Action – PubMed
Bringing True Accountability to Healthcare – John Hopkins Medicine
Mirror Mirror on the Wall – how the performance of the US Health System compares internationally  – The Commonwealth Fund
Missed hypothyroidism diagnosis uncovered by linking laboratory and pharmacy data – NCBI 14th March 2005
Data and statistics – World Health Organisation
Multistate Point-Prevalence Survey of Health Care–Associated Infections – NEJM March 2014
WHO Surgical Site Infection Prevention Guidelines – World Health Organisation
Hand washing stops infections, so why do health care workers skip it? – May 2016 The Conversation
New System for Patients to Report Medical Mistakes – New York Times

 

  • Percent of the time Australian patients were found to have received ‘appropriate’ care 57%
  • Percent of Australian patients were found to be missing significant information in their discharge records 50%
  • Percent of Australian patients were found in a study to have an incorrect diagnosis in their discharge records 10%
  • Percent of deceased UK hospital patients found by a study to have their death caused by preventable errors 50%

    Hospital acquired infections

    HAI Data and Statistics – Centers for disease control and prevention-  January 9th 2018 USA
    Here’s how many people get infections in Australian hospitals every year – The Conversation 16th August 2017
    The burden of healthcare-associated infection in Australian hospitals: A systematic review of the literature – Infection, disease and health – Volume 22, Issue 3, September 2017, Pages 117-128
    The impact of hospital-acquired bloodstream infections. – Emergency Infectious Diseases. 2001 Mar-Apr; 7(2): 174–177.
    Hand hygiene Australia – National data 2017
    What Are Nosocomial Infections? – Healthline newsletter October 24, 2016
    Nosocomial infections – Continuing Education in Anaesthesia Critical Care & Pain, Volume 5, Issue 1, 1 February 2005, Pages 14–17

    • Percent of 12.5 million USA patients hospitalized and over the age of 65, found to experience complications due to delirium 20%
    • Percent of Australian patients in a sample of deceased hospital patients, who’s medium age was 83, and did not have end of life wished documented 82%
    • Time the onset of diabetes occurs before clinical diagnosis, despite warning signs 5.5 years%
    • Of patients who died during the 15-year study period, what percent experienced a major error in their care which contributed to morbidity or mortality? 20%
    • Percentage of variation between patients receiving best practice care for diabetes, at facilities using electronic health records versus those using paper records 44%
    • Percent of patients with diabetes, who regularly undertook their diabetic retinopathy screening program 30%
    • What percent of people with diabetes were reported to regularly not taking their insulin 20%
    • What percent of patients with type 2 diabetes fail to achieve adequate glycemic control, with one of the major contributing factors being poor medication adherence. 45%
    • What percent of all deaths in under 40 year old among people with type 1 diabetes is due to ‘dead in bed’ syndrom 6%
    • Estimated time savings for Doctors using AI applications like voice-to-text transcribing and diagnosis algorithms 17%
    • Estimated time saving for Registered Nurses using AI applications like virtual nursing assistants and smart devices reading vital signs 51%

    Books on the health industry

     

    Without Due Care- Therese Mackay
    How Safe is your Prescription? Ken Lee
    Unaccountable – Marty Makary 
    The Patient will see you now – Eric Topol
    Making the cut – Mohamed Khadra
    The Patient – Mohamed Khadra
    Terminal Decline – Mohamed Khadra
    Being Mortal: Medicine and What Matters in the End –  Atul Gawande
    Vital Signs: Stories from Intensive Care – Ken Hillman
    Through a glass darkly – Caroline Jones
    Damned if I do – Philip Nitschke
    The Phoenix Rises – Colin McGill
    Get well soon – Kristy Chambers
    How Doctors think – Jerome Groopman

     

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