-- Robert Preidt
THURSDAY, Sept. 19 (HealthDay News) -- Nearly 43 million cases
of patients being harmed by medical care in hospitals occur
worldwide each year, and two-thirds of those cases occur in low-
and middle-income countries, a new review reveals.
Researchers analyzed 4,000 articles published since 1976 that
examined substandard care given to hospital patients around the
The review authors focused on seven key facets of poor care:
harm from prescribed drugs; catheter-associated urinary tract
infections; catheter-associated bloodstream infections;
hospital-acquired pneumonia; blood clots; falls; and bedsores.
For every 100 hospital admissions, about 14 cases of substandard
care occurred in high-income countries and nearly 13 cases occurred
in low- and middle-income countries. These caused nearly 17 million
cases of harm in high-income countries, and nearly 26 million cases
of harm in low- and middle-income countries.
In high-income countries, the most common type of substandard
care involved harm from medicines, which occurred in 5 percent of
hospital stays. In low- and middle-income countries, blood clots
were the most common issue, occurring in 3 percent of hospital
stays, the investigators found.
Substandard hospital care resulted in 22.6 million years of life
lost to death or disability. Low- and middle-income countries had
twice as many years lost to death or disability as high-income
countries -- 15.5 million versus 7.2 million -- according to the
study published online Sept. 18 in the journal
BMJ Quality & Safety.
Premature death accounted for the largest proportion of years of
life lost to death or disability for all seven facets of poor
hospital care -- more than 80 percent in low- and middle-income
countries and more than 78 percent in high-income countries,
according to a journal news release.
All patients should be able to rely on safe and high-quality
care when they're in a hospital, concluded researchers Dr. Ashish
Jha, at the Harvard School of Public Health, and colleagues.
"When patients are sick, they should not be further harmed by unsafe care," they wrote, adding: "This should be a major policy emphasis for all nations."
One expert noted that some of the findings have particular
import for the United States.
"The study's finding that adverse drug events were the most common adverse events in high-income countries - comprising 5 percent of unsafe medical incidents - resonated with what's happening here in the United States," said Robin Diamond, chief patient safety officer at The Doctors Company, a physician-owned medical malpractice insurer based in Napa, Calif.
"But we should pay special attention to the fact that adverse drug events are preventable in this country the vast majority of times," Diamond added.
"Unless patients are engaged in their own health care, the likelihood of medical error - even as a hospital inpatient - is much more significant," Diamond said.
"I hope a major outgrowth of this research will be the development of more standardized data collection systems to help us examine this issue - which is not just limited by our country's boundaries - from a population health standpoint," Diamond added.
The U.S. Agency for Healthcare Research and Quality offers tips
choosing quality health care.
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