PMID- 28646442
OWN - NLM
STAT- MEDLINE
DCOM- 20180910
LR  - 20181113
IS  - 1970-9366 (Electronic)
IS  - 1828-0447 (Linking)
VI  - 12
IP  - 7
DP  - 2017 Oct
TI  - Variability of adverse events in the public health-care service of the Tuscany 
      region.
PG  - 1033-1042
LID - 10.1007/s11739-017-1698-5 [doi]
AB  - The objective of the study is to analyze the variation of adverse events (AEs) 
      according to the different structure of hospitals. The study is a multicenter, 
      retrospective study. It involves 4 teaching hospitals (THs) and 32 community 
      hospitals, distributed in 12 local trusts (LTs), of the Tuscany Regional 
      Healthcare Service (RHS). A random sample of the clinical records of patients 
      admitted in LTs and THs in 2008 was selected from the database of the hospital 
      discharge records of the centers. Among 11,293 clinical records included, a total 
      of 354 adverse events were identified. There was a significant higher incidence 
      of AEs in the male and elderly (>65 years) population, and the incidence of AEs 
      was more relevant in the THs (5.3, 95% CI 4.7-6.1) than in the LTs (1.8, 95% CI 
      1.5-2.2). AEs related to falls were significantly more preventable in THs (OR 
      19.22, 95% CI 2.45-151.02), while in LTs, AEs related to infections were the most 
      preventable (OR 6.22, 95% CI 1.35-28.67). Concerning the consequence of AE, death 
      is significantly more probable for AEs related to unexpected cardiac arrest in 
      LTs, while disability and prolongation of the stay are significantly more 
      probable consequences associated with re-admission in THs, and to transfer to ICU 
      or HDU in LTs. Re-interventions, surgical complications and falls are the factors 
      more correlated with AEs. In conclusion, the study shows a higher risk of 
      incurring adverse events for the THs compared to the LTs, presumably connected 
      with a major complexity of the clinical cases. Furthermore, the preventability of 
      AEs is higher in the LTs (56.1 vs 42.2%), and this might be associated with lower 
      expertise in managing complications in these settings. Concerning specialties, 
      there are no significant differences in AEs distribution.
FAU - Albolino, Sara
AU  - Albolino S
AD  - Centre for Clinical Risk Management and Patient Safety, Tuscany Region, Villa La 
      Quiete alle Montalve, Via Pietro Dazzi, 1, 50141, Florence, Italy. 
      albolinos@aou-careggi.toscana.it.
FAU - Tartaglia, Riccardo
AU  - Tartaglia R
AD  - Centre for Clinical Risk Management and Patient Safety, Tuscany Region, Villa La 
      Quiete alle Montalve, Via Pietro Dazzi, 1, 50141, Florence, Italy.
FAU - Bellandi, Tommaso
AU  - Bellandi T
AD  - Centre for Clinical Risk Management and Patient Safety, Tuscany Region, Villa La 
      Quiete alle Montalve, Via Pietro Dazzi, 1, 50141, Florence, Italy.
FAU - Bianchini, Elisa
AU  - Bianchini E
AD  - Institute for Cancer Prevention, Florence, Italy.
FAU - Fabbro, Giancarlo
AU  - Fabbro G
AD  - Institute for Cancer Prevention, Florence, Italy.
FAU - Forni, Silvia
AU  - Forni S
AD  - Regional Agency for Quality in Healthcare, Florence, Italy.
FAU - Cernuschi, Giulia
AU  - Cernuschi G
AD  - Department of Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore 
      Policlinico, Universita degli studi di Milano, Milan, Italy.
FAU - Biggeri, Annibale
AU  - Biggeri A
AD  - Institute for Cancer Prevention, Florence, Italy.
LA  - eng
GR  - CUP E35J09000030001/Ministero della Salute/
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170623
PL  - Italy
TA  - Intern Emerg Med
JT  - Internal and emergency medicine
JID - 101263418
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - *Incidence
MH  - Italy
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Medical Errors/*classification/statistics & numerical data
MH  - Middle Aged
MH  - Patient Safety/standards/statistics & numerical data
MH  - Public Health/*standards/statistics & numerical data
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Adverse events
OT  - Clinical risk
OT  - Clinical settings
OT  - Patient safety
OT  - Retrospective record review
EDAT- 2017/06/25 06:00
MHDA- 2018/09/11 06:00
CRDT- 2017/06/25 06:00
PHST- 2017/01/02 00:00 [received]
PHST- 2017/06/13 00:00 [accepted]
PHST- 2017/06/25 06:00 [pubmed]
PHST- 2018/09/11 06:00 [medline]
PHST- 2017/06/25 06:00 [entrez]
AID - 10.1007/s11739-017-1698-5 [pii]
AID - 10.1007/s11739-017-1698-5 [doi]
PST - ppublish
SO  - Intern Emerg Med. 2017 Oct;12(7):1033-1042. doi: 10.1007/s11739-017-1698-5. Epub 
      2017 Jun 23.