The Article in Brief

Background To improve safety, hospitals often rely on voluntary reporting of errors and near misses; however, many medical injuries occur during care that is appropriate. Identifying errors by focusing on patient health, rather than errors, can provide additional information about patient safety problems. This study uses such a model to identify medical injuries among patients discharged from Wisconsin hospitals and to estimate related deaths.

What This Study Found In 2002, 13.8% of patients in Wisconsin hospitals experienced a medical injury. Those who had a medical injury had a 48% higher risk of death. Medical injury and risk of in-hospital death were higher among older patients who had multiple medical conditions. Multiple medical conditions must be taken into account to avoid inflating estimates of in-hospital medical injuries.

Implications

• The number of deaths directly attributable to medical injury may not be as high as previously thought when the patient’s medical conditions are fully considered.
• Family physicians can help improve patient safety by assisting with hospitalization decisions, coordinating patients’ care, and managing their chronic illnesses.