- Background: The Scope of the Problem
In November of 1999, the Institute of Medicine issued a report titled "To Err is Human: Building a Safer Health System." The report indicated that as many as 44,000 to 98,000 patients die in hospitals each year as a result of medical errors. As a result of this analysis and related media attention, the issue of medical errors and patient safety has continued to spark growing concern as a major problem in the current U.S. health care system. An example of this continuing awareness includes the efforts of the Institute for Health Care Improvement which has established a campaign to protect patients from incidents of medical harm.
Although the problem of medical errors is not new, the institutional focus bearing on the issue has increased considerably in recent years. For instance, a body of research supported by the Agency for Health Care Research and Quality (AHRQ) examining this issue has emerged since the early 1990's. As well, consumer awareness of the problem and concerns about its potential effect continues unabated.
- Research Objective
In light of this important issue for the future of the U.S. health care system, the Health Section of the Society of Actuaries is seeking researchers to estimate the direct and indirect costs of medical errors to the system itself and the overall U.S. economy.
The basic methodology desired for this project is to first estimate the rate of preventable adverse medical events. For the purposes of this request for proposals, a preventable adverse event is defined as an injury caused by medical management rather than the actual progression of an illness or disease. Using the estimated rate of preventable adverse events, the economic impact of these events would then be calculated. The ultimate economic consequences would include consideration of direct and indirect monetary costs such as employment productivity losses, disablement/rehabilitation expenses, and additional health care utilization needed.
A primary objective for this request for proposals is to gauge the impact of preventable adverse events in hospital settings. In addition, the analysis should be expanded to include both outpatient and prescription drug situations, to the extent possible.
An expected output from the ultimate report would be information that could help support future cost/benefit analyses for any proposed investments in the U.S. health care system to address medical errors. As well, it is envisioned that the final report will be of benefit to health professionals and organizations wanting to gain an understanding of the magnitude of the problem of medical errors.
- Proposal
To facilitate the evaluation of proposals, the following information should be submitted:
- Resumes of the authors, including any graduate student(s) expected to participate, indicating how their background, education, and experience bear on their qualifications to undertake the research. If more than one author is involved for each report, a single individual should be designated as the lead researcher and primary contact. The person submitting the proposal must be authorized to speak on behalf of all the authors as well as for the firm or institution on whose behalf the proposal is submitted.
- An outline of the approach to be used. Details should be given regarding the manner in which appropriate published material will be identified and evaluated, lines of business to evaluate, proposed methodology for quantifying costs, and possible limitations of the review and analysis
- Cost estimates for the research, including computer time, salaries, report preparation, research costs, etc. Such estimates can be in the form of hourly rates, but in such cases, time estimates should also be included. Any guarantees as to total cost should be given and will be considered in the evaluation of the proposal. While cost will be a factor in the evaluation of the proposal, it will not necessarily be the decisive factor.
- A schedule for completion of the research, identifying key dates or time frames for research completion and report submission.
- Other related factors that give evidence of a proposer's capabilities to perform in a superior fashion should be detailed.
- Selection Process
The SOA's Health Section Council is responsible for the selection of the proposal to be funded. Input from other knowledgeable individuals may also be sought, but the SOA's Health Section Council will make the final decision. The SOA's Research Actuary will provide staff actuarial support. A Project Oversight Group (POG) will be appointed to oversee the project upon selection of the proposal.
- Questions
Any questions regarding this RFP should be directed to:
- Steven Siegel, SOA Research Actuary
- ph: 847.706.3578
- f: 847.273.8578
- Notification of Intention to Submit Proposal
If you intend to submit a proposal, please e-mail written notification by April 1, 2009 to:
- Submission of Proposal
Please e–mail a copy of the proposal to: Barbara Scott.
Proposals must be received no later than April 15, 2009. It is anticipated that all authors who have submitted proposals will be informed of the status of their proposal no later than May 15, 2009.
Note: Proposals are considered confidential and proprietary.
- Conditions
The SOA reserves the right to not award a contract for this research. Reasons for not awarding a contract could include, but are not limited to, a lack of acceptable proposals or a finding that insufficient funds are available. The SOA also reserves the right to redirect the project as is deemed advisable.
The SOA intends to copyright and publish the results of this research. The research will be considered work–for–hire and all rights thereto belong to the SOA. However, appropriate credit will be given to the researcher(s).