Extent of Medical "adverse evetns" in Canada

[Hari Kumar <hari.kumar@xxxxxxxxxxxx>]

http://www.cmaj.ca/cgi/content/full/170/11/1678
Abstract The Canadian Adverse Events Study: the incidence of adverse
events among hospital patients in Canada G. Ross Baker, Peter G. Norton,
Virginia Flintoft, Régis Blais, Adalsteinn Brown, Jafna Cox, Ed
Etchells, William A. Ghali, Philip Hébert, Sumit R. Majumdar, Maeve
O'Beirne, Luz Palacios-Derflingher, Robert J. Reid, Sam Sheps and Robyn
Tamblyn
Background: Research into adverse events (AEs) has highlighted the need
to improve patient safety. AEs are unintended injuries or complications
resulting in death, disability or prolonged hospital stay that arise
from health care management. We estimated the incidence of AEs among
patients in Canadian acute care hospitals.

Methods: We randomly selected 1 teaching, 1 large community and 2 small
community hospitals in each of 5 provinces (British Columbia, Alberta,
Ontario, Quebec and Nova Scotia) and reviewed a random sample of charts
for nonpsychiatric, nonobstetric adult patients in each hospital for the
fiscal year 2000. Trained reviewers screened all eligible charts, and
physicians reviewed the positively screened charts to identify AEs and
determine their preventability.

Results: At least 1 screening criterion was identified in 1527 (40.8%)
of 3745 charts. The physician reviewers identified AEs in 255 of the
charts. After adjustment for the sampling strategy, the AE rate was 7.5
per 100 hospital admissions (95% confidence interval [CI] 5.7– 9.3).
Among the patients with AEs, events judged to be preventable occurred in
36.9% (95% CI 32.0%–41.8%) and death in 20.8% (95% CI 7.8%–33.8%).
Physician reviewers estimated that 1521 additional hospital days were
associated with AEs. Although men and women experienced equal rates of
AEs, patients who had AEs were significantly older than those who did
not (mean age [and standard deviation] 64.9 [16.7] v. 62.0 [18.4] years;
p = 0.016).

Interpretation: The overall incidence rate of AEs of 7.5% in our study
suggests that, of the almost 2.5 million annual hospital admissions in
Canada similar to the type studied, about 185 000 are associated with an
AE and close to 70 000 of these are potentially preventable.
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