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Medical records flagged during the initial screening are reviewed by a doctor, who determines the extent of the harm. In the four studies, which examined records of more than 4,200 patients hospitalized between 2002 and 2008, researchers found serious adverse events in as many as 21 percent of cases reviewed and rates of lethal adverse events as high as 1.4 percent of cases. By combining the findings and extrapolating across 34 million hospitalizations in 2007, James concluded that preventable errors contribute to the deaths of 210,000 hospital patients annually. That is the baseline. The actual number more than doubles, James reasoned, because the trigger tool doesn’t catch errors in which treatment should have been provided but wasn’t, because it’s known that medical records are missing some evidence of harm, and because diagnostic errors aren’t captured. An estimate of 440,000 deaths from care in hospitals “is roughly one-sixth of all deaths that occur in the United States each year,” James wrote in his study. He also cited other research that’s shown hospital reporting systems and peer-review capture only a fraction of patient harm or negligent care. “Perhaps it is time for a national patient bill of rights for hospitalized patients,” James wrote. “All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes.” Dr. Lucian Leape, a Harvard pediatrician who is referred to the “father of patient safety,” was on the committee that wrote the “To Err Is Human” report. He told ProPublica that he has confidence in the four studies and the estimate by James. Members of the Institute of Medicine committee knew at the time that their estimate of medical errors was low, he said.
Cobb said the school is working through the SAMC Foundation and other avenues to increase financial aid opportunities for students. Cobb also said the school works with students through exit counseling to help them get a better handle on their debt burden and their options for repayment, including programs that take students’ income into account when establishing monthly payments. Kayla Benton is one of the ACOM students funding her education through a scholarship opportunity. Benton is getting a National Health Service Corporation scholarship to attend ACOM. The scholarship pays her tuition in exchange for her service in an underserved rural area after she finishes medical school. Benton, whose husband works here, hopes to stay in the Dothan area, as 61 of 67 Alabama counties are designated as areas underserved by primary care physicians. “It’s a big burden lifted off my shoulders and I really appreciate the scholarship,” she said. Garrett Phipps and Skyler Brown joined the military to pay for medical school. Phipps signed on with the Air Force, while Brown joined the Army. Both are receiving scholarships that pay full tuition, cover costs associated with books and fees and provide a living stipend. Brown got a $20,000 sign-on bonus.