医疗事故为美国第三大致死原因

医疗事故为美国第三大致死原因 　　(N)You’ve heard those hospital horror stories where the surgeon removes the wrong body part or operates on the wrong patient or accidentally leaves medical equipment in the person they were operating on. 　　(N)你一定听说过那些医院里发生的可怕事件，比如外科医生切除了身体错误的部分;做手术把病人弄错了;或者意外将医疗器械留在了病人身体里。 　　Even scarier, perhaps, is a new study in the latest edition of BMJ suggesting most medical errors go unobserved, at least in the official record. 　　更为骇人听闻的是，也许，如《英国医学期刊》(BMJ)的最新报道，大部分的医疗事故根本未被统计进来，至少在官方记录里如此。 　　In fact, the study, from doctors at Johns Hopkins, suggests medical errors may kill more people than lower respiratory diseases like emphysema and bronchitis do. That would make these medical mistakes the third leading cause of death in the United States. That would place medical errors right behind heart disease and cancer. 　　事实上，由约翰霍普金斯大学医学院的教授们进行的这项研究显示，每年因医疗事故死亡的病人远远高于因患气肿或支气管炎等呼吸道疾病死亡的人数。医疗事故成了美国的第三大致死原因，仅次于心脏病和癌症。 　　Through their analysis of four other studies examining death rate information, the doctors estimate there are at least 251,454 deaths due to medical errors annually in the United States. The authors believe the number is actually much higher, as home and nursing home deaths are not counted in that total. 　　通过对死亡率信息的另外四项分析，这些教授们估计，在美国每年至少有25.1454万人死于医疗事故。笔者相信真实数据一定远不止这个数，因为在家里或疗养院死亡的数字并未被计入。 　　This is a much greater number than a highly cited 1999 study from the Institute of Medicine that put the number in the 44,000 to 98,000 range. Other studies have put estimates closer to 195,000 deaths a year. The U.S. Department of Health and Human Services Office of the inspector general in 2008 reported 180,000 deaths by medical error among Medicare patients alone. 　　与常常被引用的美国医学研究所在1999年发布的数据4.4万-9.8万的范围相比，这个数字显著增多。还有一些其它的研究认为这个数据大概是19.5万。美国健康和人类服务监察办公室在2008年曾报道过，因医疗事故致死的人数为18万，不过它仅追踪的是有医疗保险的病人。 　　Dr. Martin Makary and Dr. Michael Daniel, who did the study, hope their analysis will lead to real reform in a health care system they argue is letting patients down. 　　进行这项研究的马丁·马卡里教授和迈克尔·丹尼尔教授表示，希望他们的分析能带来医疗系统真正的改革，因为当前的情况实在太让患者失望了。 　　One reason there’s such a wide range of numbers is because accurate data on these kinds of deaths is surprisingly sparse. That’s in part because death certificates don’t ask for enough data, Makary said. Currently the cause of death listed on the certificate has to line up with an insurance billing code. Those codes do not adequately capture human error or system factors. 　　这些数据差异如此大，原因之一是对这类死亡的精确统计惊人的少。一方面是由于患者的死亡证明上并未要求显示完整的信息。马卡里教授说。当前在死亡证明上的死因，需要与保险帐单代码上的对应，而这些代码并未充分抓取如医疗事故或系统因素等。 　　"Billing codes are designed to maximize billing rather than capture medical errors," Makary said.The study gives an example of exactly how limited the death certificates are when it comes to recording medical errors. One example involved a patient who had a successful organ transplant and seemed healthy, but had to go back to the hospital for a non-specific complaint. During tests to determine what was wrong, a doctor accidentally cut her liver and hadn’t realized it. The hospital sent her home, but she returned with internal bleeding and went into cardiac arrest and later died. It was the cut that led to her death, but her death certificate only listed a cardiovascular issue as the cause. 　　马卡里说，“保险帐单代码的设计就是为了使帐单最大化，而不是用来抓取医疗事故。”这项研究给出了一个实例，以证明当提及医疗事故统计时，死亡证明上的信息如何具有局限性。这个病例是这样的：一个病人曾成功进行了器官移植，似乎已恢复了健康，但又因不明原因的病痛再次来到医院。一个医生在为她做检查以找出病因时，不小心切除了她的肝脏，且医生未意识到。之后她出院回家，内出血，再次来到医院抢救，因心搏骤停而死亡。正是肝脏的意外切除导致了她的死亡，然而她的死亡证明上写的却是心血管疾病。 　　Makary believes there should be a space on the certificate that asks if the death is related to a medical error. If the answer is yes, Makary suggests the doctor should have some legal protection so the certificate is not something that could be used in a lawsuit. 　　马卡里相信，死亡证明应该是有改善的空间，以确认死亡是否与医疗事故有关。如果有关，他建议医生应当受一定的法律保护，即该死亡证明不应当导致医生被起诉。 　　There are barcodes that could be placed on each piece of surgical equipment so a team could account for every tool at the end of a surgery, for example. Makary believes many hospitals don’t invest in technology that could prevent errors because the hospitals don’t always realize how big the problem is and don’t make it a priority. Funding for research on medical errors is also extremely limited. 　　另外还比如，可以给每个医疗器械贴上条形码，这样医生们在手术结束后就可清点数量避免意外。马卡里相信很多医院不愿意去投资科技以预防医疗事故，因为它们还未意识到这些问题有多严重，也不会优先考虑这一块。而用于医疗事故研究的资金也是少得可怜。 　　The problem is not unique to the United States. Earlier studies have shown undercounted medical errors are a problem in hospitals throughout the world. 　　这个问题不是只有美国才有。更早的研究显示，数不胜数的医疗事故一直是全球各地医院的一大困扰。 　　Doctors are human and they are going to make mistakes, Makary said. 　　马卡里说，医生也是人，难免会犯错误。 　　"I think doctors and nurses and other medical professionals are the heroes of the patient safety movement and come up with creative innovations to fix the problems," he said. "But they need the support from the system to solve these problems and to help us help improve the quality of care." 　　他表示，“我认为医护人员以及其他的工作人员是患者安全改善的英雄，他们能找到创新技术解决这个难题。不过他们需要的支持以解决问题，从而帮助我们改善医疗质量。”