Medical Errors Related to Discontinuity of Care from an Inpatient to an Outpatient Setting

Authors


  • Presented at the Society of General Internal Medicine 25th Annual Meeting as an Oral Presentation, Atlanta, Ga, May 2–4, 2002, and published in abstract form in Assessing medical errors related to the continuity of care from an inpatient to an outpatient setting. J Gen Intern Med. 2002;17(suppl 1):218.

Address correspondence and requests for reprints to Dr. Moore: Division of General Internal Medicine, Mount Sinai School of Medicine, 1470 Madison Ave., New York, NY 10029 (e-mail: carlton.moore@mssm.edu).

Abstract

OBJECTIVE: To determine the prevalence of medical errors related to the discontinuity of care from an inpatient to an outpatient setting, and to determine if there is an association between these medical errors and adverse outcomes.

PATIENTS: Eighty-six patients who had been hospitalized on the medicine service at a large academic medical center and who were subsequently seen by their primary care physicians at the affiliated outpatient practice within 2 months after discharge.

DESIGN: Each patient's inpatient and outpatient medical record was reviewed for the presence of 3 types of errors related to the discontinuity of care from the inpatient to the outpatient setting: medication continuity errors, test follow-up errors, and work-up errors.

MEASUREMENTS: Rehospitalizations within 3 months after the initial postdischarge outpatient primary care visit.

MAIN RESULTS: Forty-nine percent of patients experienced at least 1 medical error. Patients with a work-up error were 6.2 times (95%confidence interval [95% CI], 1.3 to 30.3) more likely to be rehospitalized within 3 months after the first outpatient visit. We did not find a statistically significant association between medication continuity errors (odds ratio [OR], 2.5; 95%CI, 0.7 to 8.8) and test follow-up errors (OR, 2.4; 95%CI, 0.3 to 17.1) with rehospitalizations.

CONCLUSION: We conclude that the prevalence of medical errors related to the discontinuity of care from the inpatient to the outpatient setting is high and may be associated with an increased risk of rehospitalization.

Ancillary