Review focused on seven facets of poor care worldwide
THURSDAY, Sept. 19, 2013 (HealthDay News) -- Nearly 43 million cases of patients being harmed by medical care in hospitals occur worldwide each year, and two-thirds of those cases occur in low- and middle-income countries, a new review reveals.
Researchers analyzed 4,000 articles published since 1976 that examined substandard care given to hospital patients around the world.
The review authors focused on seven key facets of poor care: harm from prescribed drugs; catheter-associated urinary tract infections; catheter-associated bloodstream infections; hospital-acquired pneumonia; blood clots; falls; and bedsores.
For every 100 hospital admissions, about 14 cases of substandard care occurred in high-income countries and nearly 13 cases occurred in low- and middle-income countries. These caused nearly 17 million cases of harm in high-income countries, and nearly 26 million cases of harm in low- and middle-income countries.
In high-income countries, the most common type of substandard care involved harm from medicines, which occurred in 5 percent of hospital stays. In low- and middle-income countries, blood clots were the most common issue, occurring in 3 percent of hospital stays, the investigators found.
Substandard hospital care resulted in 22.6 million years of life lost to death or disability. Low- and middle-income countries had twice as many years lost to death or disability as high-income countries -- 15.5 million versus 7.2 million -- according to the study published online Sept. 18 in the journal BMJ Quality & Safety.
Premature death accounted for the largest proportion of years of life lost to death or disability for all seven facets of poor hospital care -- more than 80 percent in low- and middle-income countries and more than 78 percent in high-income countries, according to a journal news release.
All patients should be able to rely on safe and high-quality care when they're in a hospital, concluded researchers Dr. Ashish Jha, at the Harvard School of Public Health, and colleagues.
"When patients are sick, they should not be further harmed by unsafe care," they wrote, adding: "This should be a major policy emphasis for all nations."
One expert noted that some of the findings have particular import for the United States.
"The study's finding that adverse drug events were the most common adverse events in high-income countries - comprising 5 percent of unsafe medical incidents - resonated with what's happening here in the United States," said Robin Diamond, chief patient safety officer at The Doctors Company, a physician-owned medical malpractice insurer based in Napa, Calif.
"But we should pay special attention to the fact that adverse drug events are preventable in this country the vast majority of times," Diamond added.
"Unless patients are engaged in their own health care, the likelihood of medical error - even as a hospital inpatient - is much more significant," Diamond said.
"I hope a major outgrowth of this research will be the development of more standardized data collection systems to help us examine this issue - which is not just limited by our country's boundaries - from a population health standpoint," Diamond added.
The U.S. Agency for Healthcare Research and Quality offers tips for choosing quality health care (http://www.ahrq.gov/patients-consumers/diagnosis-treatment/hospitals-clinics/quick/ ).
SOURCE: Robin Diamond, MSN, JD, RN, chief patient safety officer, The Doctors Company, Napa, Calif.; BMJ Quality & Safety, news release, Sept. 18, 2013