PMID- 12800445
OWN - NLM
STAT- MEDLINE
DCOM- 20031015
LR  - 20191107
IS  - 0043-5325 (Print)
IS  - 0043-5325 (Linking)
VI  - 115
IP  - 10
DP  - 2003 May 30
TI  - The epidemiology of medical errors: a review of the literature.
PG  - 318-25
AB  - BACKGROUND: Medical errors are one of the most important quality problems in 
      health care today. The best insight into the incidences and characteristics of 
      medical errors is through studies on adverse events (AEs) since a considerable 
      fraction of AEs are results of errors and as such preventable. Even though 
      prevention is where effort should be directed to, only a few studies report on 
      the preventability of AEs. Our aim is to give an overview of the literature 
      reporting on AEs and their preventability. METHODS: We systematically searched 
      Medline and Embase for literature published between 1980 and June 2002. All 
      articles reporting primary data on incidences of AEs and their preventability 
      were included. RESULTS: The 8 articles retrieved were divided into two 
      categories. 1) Four large scale retrospective studies: They reported incidences 
      of AEs between 2.9% and 16.6% of all hospitalizations that were judged as 
      preventable in 48.0-69.6% and negligent in up to 32.3%. 2) Four prospective 
      studies: The reported rates of AEs vary remarkably (0.0037-39.0%) because of 
      different detection methods used, different definitions applied and different 
      health care settings studied. One prospective observational study identified AEs 
      in 39.0% of hospitalized patients with a preventability of 18.0%. Two other 
      studies, using process oriented incidence reporting detected rather low rates of 
      AEs (4.2-5.4%) which were preventable in up to 62.5%. One prospective study in 
      the outpatient setting, using voluntary incidence reporting detected only about 
      3.7 events per 100,000 clinic visits of which a high fraction was judged to be 
      preventable (83.0%). IMPLICATIONS: Incidence, medical outcome and costs of AEs 
      warrant this issue to be high on any countries health care agenda. The U.S., 
      Australia and Britain have adopted this challenge by creating a centre for 
      quality improvement and patient safety within the health service and by enacting 
      new laws. But real improvement of patient safety will need a fundamental change 
      in medicine from a culture of individual blame and guilt to a culture of 
      learning, system thinking and executive responsibility.
FAU - von Laue, Nicoletta C
AU  - von Laue NC
AD  - Department of Health Policy and Management, University Witten/Herdecke, Witten, 
      Germany. nicoletta_vonlaue@hotmail.com
FAU - Schwappach, David L
AU  - Schwappach DL
FAU - Koeck, Christian M
AU  - Koeck CM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - Austria
TA  - Wien Klin Wochenschr
JT  - Wiener klinische Wochenschrift
JID - 21620870R
SB  - IM
MH  - Cross-Cultural Comparison
MH  - Cross-Sectional Studies
MH  - Humans
MH  - Incidence
MH  - Medical Errors/legislation & jurisprudence/prevention & control/*statistics & 
      numerical data
MH  - Quality Assurance, Health Care/legislation & jurisprudence
RF  - 39
EDAT- 2003/06/13 05:00
MHDA- 2003/10/16 05:00
CRDT- 2003/06/13 05:00
PHST- 2003/06/13 05:00 [pubmed]
PHST- 2003/10/16 05:00 [medline]
PHST- 2003/06/13 05:00 [entrez]
AID - 10.1007/BF03041483 [doi]
PST - ppublish
SO  - Wien Klin Wochenschr. 2003 May 30;115(10):318-25. doi: 10.1007/BF03041483.