Hospital Care Harms One In Ten, UK Study

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Main Category: Public Health
Article Date: 29 Nov 2007 - 18:00 PDT

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A UK study has suggested that one in ten national health service (NHS) patients in hospital could be harmed as a result of their care.

The study is to be published in the December issue of the BMJ journal Quality and Safety in Health Care and is the work of Professor Trevor Sheldon, of the Department of Health Sciences, University of York, UK, and colleagues.

The study was a two-stage structured retrospective case note review, where Sheldon and colleagues looked in case notes of a random sample of 1,006 patients admitted to a large teaching hospital in Northern England between January and May 2004. Although the notes relate only to one hospital, the researchers said their findings are likely to be typical of other similar hospitals.

The case notes related to 8 specialty groups: 311 to surgery, 251 to general medicine, 184 to elderly, 131 to orthopaedic, 61 to urology, and 68 to patients requiring cancer, ear nose and throat, and eye disease care.

The researchers reviewed the notes to evaluate three types of outcome measures: the proportion of admissions with adverse events, the proportion of preventable adverse events and the types and consequences of adverse events.

They used a six-point scale to determine the strength of harm an incident caused and how easily it could have been prevented in each of the 8 specialty groups.

The results showed that:

• 87 (8.7 per cent) of the 1,006 cases reviewed had at least one adverse event.
• Of these, 27 (31 per cent) were preventable, 15 per cent led to impairment of disability lasting more than 6 months, and 10 per cent contributed to patient death.
• Adverse events prolonged length of hospital stay by an average of 8 days.
• Surgery patients were more likely to come to harm, but these incidents were less preventable.
• Diagnostic errors were less common but more preventable.
• The largest category of problematic events involved unplanned admission or readmission due to previous treatment in hospital.
• The next most common types of adverse events included: falls, burns, pressure sores, heart attacks and deep vein thrombosis.

The researchers concluded that:

"This study confirms that adverse events are common, serious and potentially preventable source of harm to patients in NHS hospitals."

Together with findings from previous UK research, the authors wrote that:

"It is now clear that 8 to 10 per cent of patients in NHS hospitals may experience some kind of adverse events."

And they added that:

"Between 30 and 55 per cent are to some extent preventable."

"Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital."
Ali Baba-Akbari Sari, Trevor A Sheldon, Alison Cracknell, Alastair Turnbull, Yvonne Dobson, Celia Grant, William Gray, Aileen Richardson.
Qual Saf Health Care 2007;16:434�"439.
doi: 10.1136/qshc.2006.021154

Click here for Quality and Safety in Health Care.

Written by: Catharine Paddock
Copyright: Medical News Today
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