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How safe is going into a hospital?

Safety of healthcare vs. aviation

Patient harm due to adverse events is among the top 10 causes of death and disability across the world. Medication error alone was responsible for over 350,000 deaths in the US in 2018. Compare this to the safety record of aviation which boasted a 0.1 death for 12 billion miles flown between 2000-2018.

Healthcare is as safe as bungee jumping

In a study conducted by the Harvard University of Public Health, hospitals were categorized under the “hazardous” category based on “encounters per fatality or adverse event” and on “lives lost per year.” Healthcare was in the same group as bungee jumping and mountain climbing on these parameters. This estimation is quite counter-intuitive as most citizens feel that they are “safe” and are “taken care of” once within the walls of a hospital. As opposed to scheduled airlines, nuclear power plants, and European rail-roads that were classified as “ultra-safe.”

Why is healthcare not safer?

It is unfair to compare healthcare with industries like aviation, which superficially seem safer. Healthcare is intrinsically diverse and more complex than any other sector. Several sources create hospitals` complexity.
1. Every disease condition is different. The medical knowledge and predictability of outcomes vary widely. Various process- and management-styles are required to deal with each condition, which further complicates the value-chain.

2. Hospitals manifest characteristics of both a production and human services enterprise.

3. All the micro-systems in a hospital are tightly intertwined and a small error upstream can cascade to cause major mistakes and possible fatalities downstream.

4. There are several key players and sometimes the power and influence are moved in different directions. For example, the power and influence exerted by doctors, insurance companies, investors/ promoters, pharma, governments, regulators, technology, and patients make the balance delicate causing further complexity.

5. There is a general deficit of trust and functional relationship between doctors and management in hospitals in up to 50%.

6. In such complex inter-relationships involving multiple professional groups, the blame game can be common.
A deeper appreciation of healthcare`s inherent complexity will lead to better alignment amongst the various stakeholders who might sometimes have different goals and objectives.