Is going to hospital more dangerous than smoking cigarettes?
Are “dirty doctors doing you damage”?
Actually it is about the same. I was prompted to think about this by the advertisement below (Australian). The message is that “every cigarette is doing you damage”. It is delivered by a “surgeon” doing an operation explaining the diseases that can result from smoking.
The surgeon does not worry about wearing a mask during the operation which made me wonder about how smoking as an activity compares to going to hospital. Smoking can give you a disease. Going to hospital can give you hospital-acquired infections (e.g. from this doctor) and problems from other medical errors. How do they compare?
Smoking kills a lot more people than going to hospital (443,000 v 71,000 in the USA). But people smoke a lot. The prospect would be slim that an identifiable level of damage would caused by every one of the 300 billion cigarettes smoked each year. There is probably a bit of poetic licence in the tagline. Nevertheless overall it is obviously damaging. A bit of work on the figures from the CDC and the Institute of Medicine report ‘To Err is Human’ reveals that when the exposure is taken into account that the risk of fatality is about the same from either pastime – be it smoking – or being a patient in a hospital. It comes to one fatality for about each 60,000 hours exposure.
Is it actually the same? Which is worse? Hard to say without a lot more reseach. But it is ironic that the advice delivered by the wise doctor contains its own message about the dangers of the “health” system. I expect this was unintentional – another error!
Image source: http://www.youtube.com/watch?v=80fux1DE1kQ
Getting the exposure figures right here would really take some doing on both outcomes (fatalities caused) and exposure but here is an approximation based on what seems to be available.
Fatality rate for smoking
Number of cigarettes and cigars per year = 316 billion
Allow 5 minutes each.
Exposure = 26.3 billion hours
Fatalities = 443,000
Rate = 59,443 hrs exposure / fatality
Fatality rate for hospital errors
Number of inpatient discharges = 36.1 million
Average stay = 4.9 days
Exposure = 4.25 billion hours
Fatalities = 71,000 (taking the average of the Institute of Medicine estimates)
Fatality rate = 59,793 hours exposure / fatality
Kohn, L.T., Corrigan, J.M. & Donaldson, M.S. (eds) 2000, To Err is Huma: Building a Safer Health System, Institute of Medicine, National Academy Press, Washington.