# Presentation: 537892

## 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

**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

**Notes:**
(Describe slide)

## Number of Emergency Department Visits for Adverse Effects of Medical Treatment

**   **

**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 devices
- 17-2*	     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 patients
- 17-4* 	     Receipt of useful information about prescription from
-       	       pharmacies
- 17-5 	     Receipt of oral counseling about medication from:
- 			a.  prescribers
-       		b.  dispensers
- 17-6           Blood donation

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

## Monitoring Program 

**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**

## Hospitals with Monitoring Programs for Adverse Medical Drug Events

- 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**

## Electronic Medical Record Use by Health Care Providers

- 2001

- 2002

- 2003

**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**

## Electronic Medical Record Use by Pharmacists

- Percent of managed care and integrated health systems

- 2001

** **

- 31

- 33

- 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 

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

- 	Number of beds

- Total

- Less than 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**

## Receipt of Useful Information about Prescriptions from Pharmacies

- Percent of patients

- 2001

** **

- 74

- 74

**Receipt of Useful Information about Prescriptions from Pharmacies**

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

- 1998

**Obj. 17-4: Developmental**

- Note: 1998 data based on pilot study results.

## Receipt of Oral Counseling from Prescribers and Pharmacists

**Receipt of Oral Counseling from Prescribers and Pharmacists**

- Percent of patients

- Pharmacists

- Prescribers

- 2000

- 1998

**Obj. 17-5**

- 2010 Target

- 90

- 100

- 30

- 10

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

- 0

- 20

- 24

- 24

- 14

- 12

##   Blood Donations, Adults 18 Years and Over:

**  ****Blood Donations, Adults 18 Years and Over:**
**1998 – 2001**
**   **

- Percent

- Total

- 2010 Target

- 1998

- 1999

- 2000

- 2001

- Source: CDC, NCHS, National Health Interview Survey.

**Obj. 17-6**

## Blood Donations by Age Group: 2001

- 25-44

- 45-64

- 65+

- Percent

**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: 2001

- Percent (age-adjusted)

- 2010 Target

- Source: CDC, NCHS, National Health Interview Survey.

- Total

- Asian

- Hispanic

- Black

- White

- Less than
- high school

- High school
- graduate

- At least
- 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

- Male

- 0

- 2

- 4

- 6

- 8

- 10

## Progress review data and slides

**Progress review data and slides**
**can be found on the web at:**

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