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Preliminary1 estimates for 2015 show a 21 percent decline in hospital-acquired conditions (HACs) since 2010. A cumulative total of 3.1 million fewer HACs were experienced by hospital patients over the 5 years (2011, 2012, 2013, 2014, and 2015) relative to the number of HACs that would have occurred if rates had remained steady at the 2010 level. The preliminary 2015 rate is 115 HACs per 1,000 discharges, down from 2013 and 2014, which had held at 121 HACs per 1,000 discharges. We estimate that nearly 125,000 fewer patients died in the hospital as a result of HACs and that approximately $28 billion in health care costs were saved from 2010 to 2015 due to the reductions in HACs.
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The methods for this preliminary 2015 update on the rates and counts of HACs and associated costs and deaths averted are largely unchanged from those previously described for 2010 to 2014. The details of these methods and the resulting data for the prior periods are online2 and details specific to this preliminary 2015 report are provided in Appendix B.
Preliminary estimates for 2015 show the national HAC rate as nearly 21 percent lower than in 2010 (see Exhibits 1 and 2). As a result of the reduction in the rate of HACs, we estimate that approximately 980,000 fewer incidents of harm occurred in 2015 than would have occurred if the rate of HACs had remained steady at the 2010 level (Exhibit 3).
Cumulatively, approximately 3.1 million fewer incidents of harm occurred in 2011, 2012, 2013, 2014, and 2015 (compared with 2010). About 42 percent of this reduction is from adverse drug events, about 23 percent from pressure ulcers, and about 15 percent from catheter-associated urinary tract infections (CAUTIs) (Exhibit 4). These HACs constituted about 34 percent, 27 percent, and 8 percent, respectively, of the HACs measured in the 2010 baseline rate.3
Exhibit 1. HAC Rates, 2010 to 2015 (Preliminary)Source: AHRQ National Scorecard Estimates from Medicare Patient Safety Monitoring System, National Healthcare Safety Network, and Healthcare Cost and Utilization Project.
Exhibit 2. Annual and Cumulative Changes in HACs, 2010 to 2015Source: AHRQ National Scorecard Estimates from Medicare Patient Safety Monitoring System, National Healthcare Safety Network, and Healthcare Cost and Utilization Project.Note: Percentages are rounded.
Exhibit 3. Total Annual and Cumulative HAC Reductions (Compared With 2010 Baseline)Source: AHRQ National Scorecard Estimates from Medicare Patient Safety Monitoring System, National Healthcare Safety Network, and Healthcare Cost and Utilization Project.
Preliminary 2015 estimates indicate that more than 37,000 fewer patients died in hospitals in 2015 as a result of the decline in HACs compared with the number of deaths related to HACs that would have occurred if the rate of HACs had remained steady at the 2010 level (Exhibit 5).
Cumulative deaths averted from 2010 through 2015 are estimated at nearly 125,000. As shown in Exhibit B2, there is variation across types of HACs in the cost savings per HAC averted and in the level of increased mortality associated with the HAC. Due to this variation, costs associated and deaths averted by HAC type are not directly proportional to the HAC reductions shown in Exhibit 4.
The preliminary estimate of a 21 percent reduction in HACs from 2010 to 2015 indicates that hospitals have made substantial progress in improving safety. An estimated 3.1 million fewer HACs were experienced by patients from 2010 to 2015 than would have occurred if the HAC rate had remained at the 2010 level.
As part of its work, AHRQ has developed a variety of methods, tools, and resources to help hospitals and other providers prevent HACs, such as infections, pressure ulcers, and falls.7 Much more work remains, even with the preliminary data indicating a 21 percent decline in the HACs we have measured for the PfP since 2010.
For additional details on methods and final data for 2010 to 2014, see Methods To Estimate the Baseline 2010 PFP National Hospital-Acquired Condition Rate, AHRQ Pub. No. 14-0046-EF, and other documents on the AHRQ PfP Web site.
Exhibit B.1 provides the Interim 2015 data on HACs. The HACs that are the focus of the PfP initiative are shown, as well as the source of the data and the corresponding measures related to each HAC. The interim rate for 2015 is 115 HACs per 1,000 discharges, which is a 20.6 percent reduction from the 2010 baseline of 145 HACs per 1,000 discharges before the start of the PfP initiative.9
The basis of the derivation of the overall 44 percent preventability estimate (which corresponds to the previously referenced 2010 Office of Inspector General estimate) is shown in Exhibit B.2, as is the basis for the PfP goal of a 40 percent reduction in preventable HACs. Also shown is the estimate that, if 44 percent were considered preventable, the overall PfP goal to prevent 40 percent of preventable HACs would result in reducing the overall rate of HACs by approximately 17.6 percent. Complete references to the documents accessed to make these assessments and projections, organized by HAC type, are provided at the end of the 2013 final report (see footnote 7).
 A paper by Furukawa, et al. indicated that in 2012 and 2013, adverse events were less frequent at hospitals that had implemented a full EHR. Although the paper did not study trends in EHR adoption or trends in adverse event rates, one may hypothesize that part of the HAC reduction seen from 2010 to 2013 and 2014 could have been partially due to increased EHR adoption and increases and improvements in EHR use.
 In 2011, this work was completed using the best available information to generate 2010 incidences and other information regarding the HACs. The sources of the estimates were identified based primarily on peer-reviewed articles published through early 2011. Other sources included reports and other information from HHS and other federally sponsored programs, as well as expert opinions. After these estimates were made, processes were established to measure and estimate national HACs starting with a 2010 measured baseline (4,757,000 HACs). In order to produce consistent estimates of cost savings and deaths averted for 2010 to 2013, the per-HAC estimates established for the costs and deaths associated with HACs in 2011 have not been modified.
Internet Citation: National Scorecard on Rates of Hospital-Acquired Conditions 2010 to 2015: Interim Data From National Efforts To Make Health Care Safer. Content last reviewed December 2016. Agency for Healthcare Research and Quality, Rockville, MD. -interim.html
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The group of 47 least developed countries (LDCs) continues to have a relatively high level of fertility, which stood at 4.3 births per woman in 2010-2015. As a result, the population of these countries has been growing rapidly, at around 2.4 % per year. Although this rate of increase is expected to slow significantly over the coming decades, the combined population of the LDCs, roughly one billion in 2017, is projected to increase by 33 % between 2017 and 2030, and to reach 1.9 billion persons in 2050.
In recent years, fertility has declined in nearly all regions of the world. Even in Africa, where fertility levels are the highest of any region, total fertility has fallen from 5.1 births per woman in 2000-2005 to 4.7 in 2010-2015.
Substantial improvements in life expectancy have occurred in recent years. Globally, life expectancy at birth has risen from 65 years for men and 69 years for women in 2000-2005 to 69 years for men and 73 years for women in 2010-2015. Nevertheless, large disparities across countries remain.
Although all regions shared in the recent rise of life expectancy, the greatest gains were for Africa, where life expectancy rose by 6.6 years between 2000-2005 and 2010-2015 after rising by less than 2 years over the previous decade.
The gap in life expectancy at birth between the least developed countries and other developing countries narrowed from 11 years in 2000-2005 to 8 years in 2010-2015. Although differences in life expectancy across regions and income groups are projected to persist in future years, such differences are expected to diminish significantly by 2045-2050.
The increased level and reduced variability in life expectancy have been due to many factors, including a lower under-five mortality rate, which fell by more than 30 % in 89 countries between 2000-2005 and 2010-2015. Other factors include continuing reductions in fatalities due to HIV/AIDS and progress in combating other infectious as well as non-communicable diseases.
There continue to be large movements of migrants between regions, often from low- and middle-income countries toward high-income countries. The volume of the net inflow of migrants to high-income countries in 2010-2015 (3.2 million per year) represented a decline from a peak attained in 2005-2010 (4.5 million per year). Although international migration at or around current levels will be insufficient to compensate fully for the expected loss of population tied to low levels of fertility, especially in the European region, the movement of people between countries can help attenuate some of the adverse consequences of population ageing.
The 2017 Revision builds on previous revisions by incorporating additional results from the 2010 and 2020 rounds of national population censuses as well as findings from recent specialized sample surveys from around the world. The 2017 Revision provides a comprehensive set of demographic data and indicators that can be used to assess population trends at the global, regional and national levels and to calculate other key indicators for monitoring progress toward the Sustainable Development Goals. 350c69d7ab