Is Patient Safety Improving?

National Trends in Patient Safety Indicators: 1998-2007

Over the past decade, significant emphasis has been placed on patient safety. New measures and systems have emerged to measure safety and quality, yet little is known about their effectiveness. This article assesses patient safety indicators (PSIs) over the past decade to examine whether national trends have improved.

This study uses data from the Nationwide Inpatient Sample (NIS) on eligible inpatient admissions between 1998 and 2007. The NIS data includes de-identified discharge data (up to 15 diagnoses and procedures) from 1,045 hospitals located in 38 states. PSI criteria were from the Agency for Healthcare Research and Quality. Annual percent changes for PSIs were estimated using joinpoint regression.

This study provides important information in understanding national trends of PSIs and demonstrating possible priority areas for quality improvement.

Special Issue of Health Services Research Links Health Care Research and Health Policy

  1. 1. Expanding the Safety-Net of Specialty Care for the Uninsured
  2. 2. Translation of Evidence-Based Clinical Standards into a New Prehospital Resuscitation Policy in Los Angeles
  3. 3. Physician Social Networks and Variation in Prostate Cancer Treatment in Three Cities
  4. 4. Value-Based Insurance Design
  5. 5. Is Patient Safety Improving?
  6. 6. The Association of Health Insurance and Disease Impairment with Reported Asthma Prevalence in U.S. Children
  7. 7. A Policy Impact Analysis of the Mandatory NCAA Sickle Cell Trait Screening Program
  8. 8. Nonfinancial Barriers and Access to Care for US Adults
  9. 9. Physician Practices and Readiness for Medical Home Reforms
  10. 10. Does a Video-Interpreting Network Improve Delivery of Care in the Emergency Department?
  11. 11. Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care
  12. 12. State-Level Variations in Racial Disparities in Life Expectancy
  13. 13. "Does this Doctor Speak My Language?"

Key Findings

  • Of the 15 PSIs considered in this study, seven PSIs had increasing annual percentage changes, including postoperative pulmonary embolism or deep vein thrombosis, postoperative physiological or metabolic derangement, postoperative sepsis, selected infections due to medical care, decubitus ulcer, accidental puncture or laceration, and postoperative respiratory failure.

  • Seven PSIs had decreasing annual percentage changes, including birth trauma injury to neonate, failure to rescue, postoperative hip fracture, obstetric trauma-vaginal without instrument, obstetric trauma-vaginal with instrument, iatrogenic pneumothorax, and postoperative wound dehiscence.

  • PSI rates fell from 454.01 per 1,000 patient admissions in 1998 to 353.15 in 2007.