Focus Area 17:Medical Product Safety

Progress Review

November 5, 2003

Health Care Quality Framework

Source: 2001 Institute of Medicine Report, Envisioning the National Health Care Quality.

Estimated Annual Burden

Adverse Medical Events 44,000 to 98,000 deaths Total national cost: $36.7 to $50 billion

Adverse Drug Events (ADE) 7,000 deaths due to medication error 2 out of 100 admissions experience

preventable ADE Average increased hospital cost of

preventable ADE: $4,700 per admission or $ 2 billion nationwide

Source: 1999 Institute of Medicine report, To Err Is Human Building a Safer Health System.

Leading Causes of Death: 2001

1. Heart disease

2. Malignant neoplasm

3. Cerebrovascular

4. Chronic lower respiratory

5. Unintentional injury

6. Diabetes

7. Influenza and pneumonia

8. Alzheimer’s disease

9. Nephritis

10. Septicemia

700,142

553,768

163,538

123,013

101,537

71,372

62,034

53,852

39,480

Adverse medical events (estimated): 44,000 – 98,000 *

Source: CDC, NCHS, National Vital Statistics System.

* Institute of Medicine report estimate.

Total Number of Deaths: 2,416,425

32,238

0

200

400

600

800

1000

1200

1400

1600

Number of Emergency Department Visits for Adverse Effects of

Medical Treatment

1992 1994 1996 1998 2000 2001

Number of visits (thousands)

Note: Data for 1994-2000 are 2-year averages. Source: CDC, NCHS, National Hospital Ambulatory Medical Care Survey.

Medical Product Safety Objectives

17-1* Monitoring of adverse medical events: a. associated with medical therapies

b. associated with medical devices17-2* Linked, automated information systems used:

a. by health care professionals in hospitals and integrated health systems b. by pharmacists and other dispensers

17-3* Provider review of medication taken by patients17-4* Receipt of useful information about prescription from pharmacies

17-5 Receipt of oral counseling about medication from:a. prescribers

b. dispensers17-6 Blood donation

*Developmental objectives; those in red have new baselines; those in grey have no baselines.

Administering-Administer right medication to patient-Administer medication when indicated-Inform patient about medication-Include patient in administration

Dispensing-Review order-Process order-Compound/Prepare drug

Prescribing-Diagnostic / Therapeutic decisions made-Medication ordered-Order verified and submitted

Monitoring Program

-Obtain medication-related history

-Document medication history

Adverse Drug Events

0

20

40

60

80

100

1998 2001

81.6 77.4

Hospitals with Monitoring Programs for Adverse Medical Drug Events

Percent of children’s and general medical surgical hospitals

Source: American Society of Health Systems Pharmacists, National Survey of Pharmacy Practice in Acute Care Settings,.

Obj. 17-1a: Developmental

2000 2001 2002 2003

19

131312

0

5

10

15

20

25

Obj. 17-2a: Developmental

Percent of health care organizations

Source: Health Information and Management Society, Annual HIMSS Leadership Survey.

Electronic Medical Record Use by Health Care Providers

0

10

20

30

40Percent of managed care and integrated health systems

2001

3133

Source: American Society of Health Systems Pharmacists, National Survey of Ambulatory Care Responsibilities of Pharmacists in Managed Care and Integrated Systems.

1999

Electronic Medical Record Use by Pharmacists

Obj. 17-2a: Developmental

Computerized Prescriber Order Entry System Utilization: 2001

4.3

1.5 1.1 1.93.5

10.1

20.4

0

5

10

15

20

25

Source: American Society of Health Systems Pharmacists, National Survey of Pharmacy Practice in Hospital Settings.

Number of beds

Total

Less th

an

50 50-99

100-199

200-299

300-399

400 or more

Percent of children’s and general medical surgical hospitals

Obj. 17-2b: Developmental

0

20

40

60

80Percent of patients

2001

74 74

Receipt of Useful Information about Prescriptions from Pharmacies

Source: FDA, National Survey of Prescription Drug Information Provided to Patients.

1998Obj. 17-4: Developmental

Note: 1998 data based on pilot study results.

Receipt of Oral Counseling from Prescribers and Pharmacists

Percent of patients

PharmacistsPrescribers

20001998

Obj. 17-5

2010 Target

90

100

30

10

Source: FDA, National Survey of Prescription Medicine Information Received by Consumers .

0

20

24 24

1412

0

2

4

6

8

10

Blood Donations, Adults 18 Years and Over:

1998 – 2001

Percent

Total

2010 Target

1998 1999 2000 2001Source: CDC, NCHS, National Health Interview Survey. Obj. 17-6

18-24 25-44 45-64 65+0

2

4

6

8

10Percent

Blood Donations by Age Group: 2001

Source: CDC, NCHS, National Health Interview Survey.Obj. 17-6

2010 Target

Blood Donations, Adults 18 Years and Over by Race/Ethnicity and

Education: 2001Percent (age-adjusted)

2010 Target

Source: CDC, NCHS, National Health Interview Survey.

TotalAsia

n

Hispanic

Black White

Less than

high school

High school

graduateAt le

ast

some college

Obj. 17-6

Note: Asian includes Pacific Islander; Black and White exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Data are age adjusted to the 2000 standard population. Education data are for persons ages 25-64 years.I = 95% confidence interval.

Female Male0

2

4

6

8

10

Progress review data and slidescan be found on the web at:

http://www.cdc.gov/nchs/hphome.htm