PMID- 19901141
OWN - NLM
STAT- MEDLINE
DCOM- 20091209
LR  - 20091110
IS  - 1538-3679 (Electronic)
IS  - 0003-9926 (Linking)
VI  - 169
IP  - 20
DP  - 2009 Nov 9
TI  - Disclosure of hospital adverse events and its association with patients' ratings 
      of the quality of care.
PG  - 1888-94
LID - 10.1001/archinternmed.2009.387 [doi]
AB  - BACKGROUND: Little is known about how the characteristics of adverse events (AEs) 
      affect the likelihood of disclosure or how the disclosure of an AE relates to 
      patients' perception of quality of care. METHODS: The study included a random 
      sample of medical and surgical acute care adult patients in Massachusetts 
      hospitals between April 1 and October 1, 2003. The unit of analysis was the AE, 
      and multivariable regression analyses accounted for clustering at the patient 
      level. RESULTS: Overall, 603 patients reported 845 AEs, and 40% of AEs were 
      disclosed. The AEs that required additional treatment (odds ratio [OR], 1.64; 95% 
      confidence interval [CI], 1.16-2.32) or affected patients who reported good 
      health (OR, 2.04; 95% CI, 1.29-3.24) were more likely to be disclosed. Disclosure 
      was less likely if the events were preventable (OR, 0.58; 95% CI, 0.41-0.83) or 
      if the patients were still affected by the AE at the time of survey (OR, 0.49; 
      95% CI, 0.31-0.78). Higher-quality ratings were associated with disclosure (OR, 
      2.04; 95% CI, 1.39-2.99) of preventable and nonpreventable events and with 
      patients who felt that they were able to protect themselves from AEs (OR, 1.98; 
      95% CI, 1.21-3.24). Lower-quality ratings were associated with events that were 
      preventable (OR, 0.55; 95% CI, 0.40-0.76), with events that caused increased 
      discomfort (OR, 0.62; 95% CI, 0.46-0.86), or with events that still adversely 
      affected the patient at the time of the survey (OR, 0.68; 95% CI, 0.46-0.98). 
      CONCLUSIONS: Rates of disclosure of AEs by medical personnel remain low in 
      hospitalized patients. Disclosure of some of these events is associated with 
      higher ratings of quality by patients.
FAU - Lopez, Lenny
AU  - Lopez L
AD  - MDiv, Institute for Health Policy, Massachusetts General Hospital, 50 Staniford 
      St, Ninth Floor, Boston, MA 02114, USA. llopez1@partners.org
FAU - Weissman, Joel S
AU  - Weissman JS
FAU - Schneider, Eric C
AU  - Schneider EC
FAU - Weingart, Saul N
AU  - Weingart SN
FAU - Cohen, Amy P
AU  - Cohen AP
FAU - Epstein, Arnold M
AU  - Epstein AM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Intern Med
JT  - Archives of internal medicine
JID - 0372440
SB  - IM
MH  - Adverse Drug Reaction Reporting Systems/statistics & numerical data
MH  - Aged
MH  - Aged, 80 and over
MH  - Confidence Intervals
MH  - Cross Infection/diagnosis/epidemiology
MH  - Female
MH  - Health Care Surveys
MH  - Hospital Mortality/*trends
MH  - Hospitals, General
MH  - Humans
MH  - Iatrogenic Disease/*epidemiology
MH  - Incidence
MH  - Logistic Models
MH  - Male
MH  - Massachusetts
MH  - Medical Errors/*statistics & numerical data
MH  - Medication Errors/statistics & numerical data
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Patient Participation
MH  - Patient Satisfaction/*statistics & numerical data
MH  - Postoperative Complications/mortality
MH  - Predictive Value of Tests
MH  - Probability
MH  - *Quality of Health Care
MH  - Risk Assessment
MH  - Sampling Studies
EDAT- 2009/11/11 06:00
MHDA- 2009/12/16 06:00
CRDT- 2009/11/11 06:00
PHST- 2009/11/11 06:00 [entrez]
PHST- 2009/11/11 06:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - 169/20/1888 [pii]
AID - 10.1001/archinternmed.2009.387 [doi]
PST - ppublish
SO  - Arch Intern Med. 2009 Nov 9;169(20):1888-94. doi: 10.1001/archinternmed.2009.387.