Risk factors for patient-reported medical errors in eleven countries
Version of Record online: 1 FEB 2012
© 2012 John Wiley & Sons Ltd
Volume 17, Issue 3, pages 321–331, June 2014
How to Cite
Schwappach, D. L. B. (2014), Risk factors for patient-reported medical errors in eleven countries. Health Expectations, 17: 321–331. doi: 10.1111/j.1369-7625.2011.00755.x
- Issue online: 28 APR 2014
- Version of Record online: 1 FEB 2012
- Accepted for publication 12 October 2011
- medical errors;
- patient-reported outcomes;
Objectives The aim of this study was to identify common risk factors for patient-reported medical errors across countries. In country-level analyses, differences in risks associated with error between health care systems were investigated. The joint effects of risks on error-reporting probability were modelled for hypothetical patients with different health care utilization patterns.
Design Data from the Commonwealth Fund’s 2010 lnternational Survey of the General Public’s Views of their Health Care System’s Performance in 11 Countries.
Setting Representative population samples of 11 countries were surveyed (total sample = 19 738 adults). Utilization of health care, coordination of care problems and reported errors were assessed. Regression analyses were conducted to identify risk factors for patients’ reports of medical, medication and laboratory errors across countries and in country-specific models.
Results Error was reported by 11.2% of patients but with marked differences between countries (range: 5.4–17.0%). Poor coordination of care was reported by 27.3%. The risk of patient-reported error was determined mainly by health care utilization: Emergency care (OR = 1.7, P < 0.001), hospitalization (OR = 1.6, P < 0.001) and the number of providers involved (OR three doctors = 2.0, P < 0.001) are important predictors. Poor care coordination is the single most important risk factor for reporting error (OR = 3.9, P < 0.001). Country-specific models yielded common and country-specific predictors for self-reported error. For high utilizers of care, the probability that errors are reported rises up to P = 0.68.
Conclusions Safety remains a global challenge affecting many patients throughout the world. Large variability exists in the frequency of patient-reported error across countries. To learn from others’ errors is not only essential within countries but may also prove a promising strategy internationally.