PMID- 31609847
OWN - NLM
STAT- MEDLINE
DCOM- 20200131
LR  - 20231014
IS  - 1537-1948 (Electronic)
IS  - 0025-7079 (Print)
IS  - 0025-7079 (Linking)
VI  - 57
IP  - 11
DP  - 2019 Nov
TI  - Comparing Rates of Adverse Events and Medical Errors on Inpatient Psychiatric 
      Units at Veterans Health Administration and Community-based General Hospitals.
PG  - 913-920
LID - 10.1097/MLR.0000000000001215 [doi]
AB  - OBJECTIVE: There is limited knowledge about how general hospitals and Veterans 
      Health Administration (VHA) hospitals fare relative to each other on a broad 
      range of inpatient psychiatry-specific patient safety outcomes.This research 
      compares data from 2 large-scale epidemiological studies of adverse events (AEs) 
      and medical errors (MEs) in inpatient psychiatric units, one in VHA hospitals and 
      the other in community-based general hospitals. METHOD: Retrospective medical 
      record reviews assessed the prevalence of AEs and MEs in a sample of 4371 
      discharges from 14 community-based general hospitals (derived from 69,081 
      discharges at 85 hospitals) and a sample of 8005 discharges from 40 VHA hospitals 
      (derived from 92,103 discharges at 105 medical centers). Rates of AEs and MEs 
      across hospital systems were calculated, controlling for relevant patient and 
      hospital characteristics. RESULTS: The overall rate of AEs and MEs in inpatient 
      psychiatric units of VHA hospitals was 7.11 and 1.49 per 100 patient discharges; 
      at community-based acute care hospitals, these rates were 13.48 and 3.01 per 100 
      patient discharges. The adjusted odds ratio of a patient experiencing an AE and a 
      ME at community-based hospitals as compared with VHA hospitals was 2.11 and 2.08, 
      respectively. CONCLUSION: Although chart reviews may not document the complete 
      nature and outcomes of care, even after controlling for differences in patient 
      and hospital characteristics, psychiatric inpatients at community-based hospitals 
      were twice as likely to experience AEs or MEs as inpatients at VHA hospitals. 
      While community-based hospitals may lag behind VHA hospitals, both hospital 
      systems should continue to pursue evidence-based improvements in patient safety. 
      Future research aimed at changing hospital practices should draw on established 
      strategies for bridging the gap from research to practice in order to improve the 
      quality of care for this vulnerable patient population.
FAU - Cullen, Sara W
AU  - Cullen SW
AD  - School of Social Policy and Practice.
FAU - Xie, Ming
AU  - Xie M
AD  - School of Medicine, University of Pennsylvania, Philadelphia, PA.
FAU - Vermeulen, Jentien M
AU  - Vermeulen JM
AD  - Department of Psychiatry, Academic Medical Center, University of Amsterdam, 
      Amsterdam, The Netherlands.
FAU - Marcus, Steven C
AU  - Marcus SC
AD  - School of Social Policy and Practice.
LA  - eng
GR  - I01 HX000702/HX/HSRD VA/United States
GR  - R01 MH086722/MH/NIMH NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Female
MH  - Hospitals, Community/*statistics & numerical data
MH  - Hospitals, General/*statistics & numerical data
MH  - Hospitals, Veterans/*statistics & numerical data
MH  - Humans
MH  - Inpatients/*psychology/statistics & numerical data
MH  - Male
MH  - Medical Errors/psychology/*statistics & numerical data
MH  - Middle Aged
MH  - Patient Discharge/statistics & numerical data
MH  - Psychiatric Department, Hospital/*statistics & numerical data
MH  - Retrospective Studies
MH  - Young Adult
PMC - PMC6813795
MID - NIHMS1538469
COIS- There are no potential conflicts of interest for all authors for the past three 
      years.
EDAT- 2019/10/15 06:00
MHDA- 2020/02/01 06:00
PMCR- 2020/11/01
CRDT- 2019/10/15 06:00
PHST- 2019/10/15 06:00 [entrez]
PHST- 2019/10/15 06:00 [pubmed]
PHST- 2020/02/01 06:00 [medline]
PHST- 2020/11/01 00:00 [pmc-release]
AID - 00005650-201911000-00011 [pii]
AID - 10.1097/MLR.0000000000001215 [doi]
PST - ppublish
SO  - Med Care. 2019 Nov;57(11):913-920. doi: 10.1097/MLR.0000000000001215.