Value-Based Care

Research brief: Hospital-acquired conditions lead to avoidable cost and excess deaths

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A new research brief from IBM Watson Health looks at the adverse outcomes attached to hospital-acquired conditions. You can read the full research brief here.


Executive summary
Hospital-acquired conditions (HACs), such as pressure ulcers, falls and trauma, and surgical site infections, are defined by the Centers for Medicare and Medicaid Services (CMS) as avoidable complications of care that could reasonably have been prevented through the  application of evidence-based guidelines1. CMS tracks 14 categories of HACs and adjusts payments to hospitals that rank in the worst-performing 25 percent of all hospitals with respect to these quality measures2.
Despite the penalties and the perceived avoidability of these conditions, research from IBM Watson Health has found there were 48,771 HACs in 2016. Together, these resulted in 3,219 potentially avoidable deaths and drove total excess hospital costs of more than $2 billion in fiscal year 2016. The excess costs represent hospital operational costs only and do not include physicians’ fees. These HACs also added an average of 8.17 days per patient to average length of stay, and increased mortality risk per patient by 72.32 percent.


The research breaks out the scope of these adverse outcomes across each of the 14 HAC categories, drawing on an inpatient database of 19,790,656 actual discharges projected to an estimated 37,102,428 civilian discharges from over 4,500 hospitals. Data was drawn from  the 2016 IBM Watson Health Projected Inpatient Database, which contains approximately 20 million discharges per year from more than 2,600 acute care hospitals, statistically projected to the entire US. This unique data set contains claims data from all payers  nationwide, including CMS and private, employer-sponsored health plans, capturing a full breadth of healthcare outcomes on a national basis.


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