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Monday, November 05, 2007

Doctors of Death: Iatrogenic disease and poor health care in the US

What does the word iatrogenic mean?
This term is defined as induced in a patient by a physician's activity, manner, or therapy. Used especially of a complication of treatment.

Bits from a 2000 article in JAMA based on 1999 statistics. The author is Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health and she describes how the US health care system may contribute to poor health.
* 12,000 -- unnecessary surgery
* 7,000 -- medication errors in hospitals
* 20,000 -- other errors in hospitals
* 80,000 -- infections in hospitals
* 106,000 -- non-error, negative effects of drugs

These total 225,000 deaths per year from iatrogenic causes! Even at the lower estimate of 225,000 deaths per year, this constitutes the third leading cause of death in the US, following heart disease and cancer!

Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings,with:
* 116 million extra physician visits
* 77 million extra prescriptions
* 17 million emergency department visits
* 8 million hospitalizations
* 3 million long-term admissions
* 199,000 additional deaths
* $77 billion in extra costs

However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care.

An estimated 44,000 to 98,000 among them die each year as a result of medical errors.

This might be tolerated if it resulted in better health, but does it? Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators.

The poor performance of the US was recently confirmed by a World Health Organization study, which used different data and ranked the United States as 15th among 25 industrialized countries.

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