Preventable in-hospital medical injury under the "no fault" system in New Zealand
Open Access
- 1 August 2003
- journal article
- research article
- Published by BMJ in Quality and Safety in Health Care
- Vol. 12 (4), 251-256
- https://doi.org/10.1136/qhc.12.4.251
Abstract
Objectives: To describe the pattern of preventable in-hospital medical injury under the “no fault” system and to assess the level of serious preventable patient harm. Design: Cross sectional survey using a two stage retrospective assessment of medical records conducted by structured implicit review. Setting: General hospitals with over 100 beds providing acute care in New Zealand. Participants: A sample of 6579 patients admitted in 1998 to 13 hospitals selected by stratified systematic list sample. Main outcome measures: Occurrence, preventability, and impact of adverse events. Results: Over 5% of admissions were associated with a preventable in-hospital event, of which nearly half had an element of systems failure. The elderly, ethnic minority groups, and particular clinical areas were at higher risk. The chances of a patient experiencing a serious preventable adverse event subsequent to hospital admission were just under 1%, a figure close to published results from comparable studies under tort. On average, these events required an additional 4 weeks in hospital. System related issues of protocol use and development, communication, and organisation, as well as requirements for consultation and education, were pre-eminent. Conclusions: The risk of serious preventable in-hospital medical injury for patients in New Zealand, a well established “no fault” jurisdiction, is within the range reported in comparable investigations under tort.Keywords
This publication has 18 references indexed in Scilit:
- Retrospective case record review: a blunt instrument that needs sharpeningQuality and Safety in Health Care, 2003
- Measuring errors and adverse events in health careJournal of General Internal Medicine, 2003
- Physicians’ Views On Quality Of Care: A Five-Country ComparisonHealth Affairs, 2001
- Management matters: the link between hospital organisation and quality of patient careQuality in health care : QHC, 2001
- Hospital Finance: Signs Of ‘Pushback’ Amid Resurgent Cost PressuresHealth Affairs, 2001
- Relation between Negligent Adverse Events and the Outcomes of Medical-Malpractice LitigationNew England Journal of Medicine, 1996
- Relation between Malpractice Claims and Adverse Events Due to NegligenceNew England Journal of Medicine, 1991
- The Nature of Adverse Events in Hospitalized PatientsNew England Journal of Medicine, 1991
- Incidence of Adverse Events and Negligence in Hospitalized PatientsNew England Journal of Medicine, 1991
- A Study of Medical Injury and Medical MalpracticeNew England Journal of Medicine, 1989