More than a quarter of Medicare patients experienced an “adverse” or harmful event during a hospitalization, according to a November report from the Office of the Inspector General.

The report also showed that in 2008, 13.5% of Medicare patients were involved in an event the caused temporary harm, while 1.5% experienced harm that resulted in death. Doctors who reviewed the OIG report determined that 44% of the events were preventable, while 51% were not preventable, reported the American Medical News.

OIG’s recommendations for responding to these number include creating clear goals for improvement and establishing incentives for improvement and disincentives for errors. Disincentives include assessing Medicare payment penalties and cutting Medicare payments for care linked to hospital-acquired conditions.