Report: Medical Injuries High

Hospitals may not be the safest place for medical care anymore, a report released last week by a team of Harvard researchers indicates.

The report, published in the Feb. 7 issue of the New England Journal of Medicine, disclosed that nearly four percent of all hospital patients in the state of New York were injured by mismanaged medical care in 1984.

Known as the Harvard Medical Practice Study, the report was the culmination of investigations by Harvard Medical School, Harvard Law School, School of Public Health, and the Kennedy School of Government researchers over the past few years.

"This is the largest, most comprehensive study of its kind carried out," said Professor of Medicine Howard H. Hiatt, the principal investigator in the Harvard Medical Practice Study. Hiatt is affiliated with both the Medical School and Brigham and Women's Hospital in Cambridge.

According to the report, as many as 100,000 hospital patients were injured by "adverse events" that lead to prolonged hospitalization, disability, or death, Hiatt said.

Erroneous drug prescriptions and wound infections topped the list of care-induced injuries, accounting for over 33 percent of these "adverse effects," Hiatt explained. Surgical mistakes accounted for more than half of the remaining injuries, he added.

An even more startling finding attributed 70 percent of emergency room misdiagnoses and botched treatments to negligence, according to Hiatt. He added, however, that according to the study, only one quarter of incidences of medical malpractice can actually be attributed to negligence.

Elderly Care

The report indicated that elderly patients are much more vulnerable to such mismanaged hospital care than are other patients.

"Presumably, this means that care for the elderly less frequently meets the standard expected of reasonable medical care," the report stated.

Based on their findings, the researchers responsible for the study have proposed several medical-care reform measures, including improvements in medical knowledge, increased emphasis on education and stricter disciplinary actions.

Hiatt went on to say that current methods of compensation for substandard care in the form of malpractice are insufficient.

"The problem of medical malpractice and the tort litigation system are not satisfactory to anybody today," Hiatt said.

The study itself was based on a review of hospital records of 30,121 patients in New York.

New York's, rather than Massachusetts's, hospital system was studied, Hiatt said, primarily because of New York's willingness to extend economic support and provide vast amounts of complex, highly sensitive data. New York State contributed $3.5 million to the $4 million cost of the study, Hiatt said.