Study Finds 6% of Medicare Patients Often Mistreated

More than 6% of Medicare patients receive poor quality care in hospitals, with strokes, respiratory failure, pneumonia and kidney problems among the most frequently mistreated conditions, according to a study by the inspector general of the Health and Human Services Department.

The government spends more than $1 billion a year for this substandard care, said the report, which is to be released soon. A copy was obtained Tuesday by The Times.

The study said that 6.6% of the sample of Medicare patients received poor quality care, a figure much higher than that found in earlier studies by private organizations that review Medicare performance under contracts from the federal government.

The inspector general’s study reviewed the records of Medicare patients discharged between October, 1984, and March, 1985. During the same time, the private groups--called peer review organizations--found poor care in less than 1% of the cases they reviewed.

“This is good solid data, not anecdotal stuff,” Inspector General Richard P. Kusserow said of the new figures in an interview.

Older Patients Affected

Patients who receive poor quality care tend to be older than the average Medicare patient. They are three times more likely to die due to inadequate treatment than ordinary Medicare patients, and four times more likely to develop a hospital-caused infection unrelated to their original illness, the report said.

The survey used a sample of 7,050 records of Medicare patients selected at random from 239 hospitals. Three panels of doctors and nurses independently reviewed the records to decide whether the patient received quality care.

The report cited these and other examples of poor care:

--A patient with epilepsy was admitted to the hospital with a heart attack. A staff member forgot to write an order to continue his epilepsy medicine. The patient had a seizure, fell out of bed and suffered a broken leg.

--A patient who had heart surgery suffered kidney failure after hospital personnel forgot to monitor his fluid levels. The procedure used in diagnosing the kidney failure dislodged a blood clot, which then blocked an artery. Doctors were forced to amputate the patient’s leg.

--A patient suffering from jaundice, excess abdominal fluid and weakness was incorrectly given morphine injections “which would not have relieved any of the symptoms.”