Going to the hospital is increasingly a risky proposition, considering that more Americans die from mistakes in the hospital than those killed by strokes and accidents combined.

A new study published in the Journal of Patient Safety estimates that between 210,000 and 440,000 patients annually don’t make it out of hospitals because of some kind of preventable harm.

These figures eclipse those reported in earlier studies that blamed bad hospital care for 98,000 deaths (1999, Institute of Medicine) and 180,000 fatalities (2010, Office of Inspector General for Health and Human Services, which only focused on Medicare patients).

The new study, produced by John T. James, a toxicologist with the National Aeronautics and Space Administration in Houston who runs an advocacy organization called Patient Safety America, means hospital deaths are now the third leading cause of death in the U.S., behind only heart disease (No. 1) and cancer (No. 2).

When asked about James’ conclusions, a spokesman for the American Hospital Association told ProPublica that the organization was inclined to stick with the Institute of Medicine’s lower number of 98,000 deaths.

However, ProPublica reached out to three prominent patient safety researchers about James’ research, “and all said his methods and findings were credible,” Marshall Allen wrote.

James, who got involved in patient safety after his teenage son died from what he claims was negligent hospital care by cardiologists in central Texas, said his numbers demonstrate the need to adopt a national patient bill of rights for hospitalized patients.

“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,” he told ProPublica.

-Noel Brinkerhoff

To Learn More:

How Many Die From Medical Mistakes in U.S. Hospitals? (by Marshall Allen, ProPublica)

A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care (by John T. James, Journal of Patient Safety)