Variability of adverse events in the public health-care service of the Tuscany region
| Autor: | Riccardo Tartaglia, Elisa Bianchini, Silvia Forni, Sara Albolino, Giancarlo Fabbro, Tommaso Bellandi, Giulia Cernuschi, Annibale Biggeri |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Population Poison control Occupational safety and health 03 medical and health sciences Patient safety 0302 clinical medicine statistica medica Injury prevention Internal Medicine medicine Humans 030212 general & internal medicine education Adverse effect Aged Retrospective Studies education.field_of_study Medical Errors business.industry 030503 health policy & services Incidence (epidemiology) Incidence Retrospective cohort study Length of Stay Middle Aged Italy Emergency medicine Emergency Medicine lipids (amino acids peptides and proteins) Female Patient Safety Public Health 0305 other medical science business |
| Zdroj: | Internal and emergency medicine. 12(7) |
| ISSN: | 1970-9366 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink