Adverse Medical Events in Hospitals Worldwide

A dramatic and sobering study on the incidence and types of adverse medical events worldwide has just been published in the journal BMC Quality and Safety.¹ The study's long list of credentials is indeed compelling, for it represents a collaboration between the Harvard School of Public Health, the World Health Organization, the Brigham & Women's Hospital of Boston, and the Health Care Quality and Outcomes Program (an offshoot of the Agency for Health Care and Quality Research), based in Durham, North Carolina. Its design is the combination of two separate literature reviews checked by external authorities and an epidemiological study conducted by the World Health Organization.

In no uncertain terms, this study delivers a shocking message: On an annual worldwide basis, no less than 10 percent of the total number of hospitalizations are accompanied by adverse medical events. Although it divides the study population into high-income and low- /middle-income countries, what stands out are these facts:

• The overall percentage of adverse events compared to the total number of hospitalizations is actually higher in the high-income countries as compared to the low-income nationalities.
• The above figure is driven by a percentage ofadverse drug events almost twice as great in the high-income as opposed to the low-income countries.
• It is also driven by a higher percentage of nosocomial pneumonia that is actually twice as great in the high-income as opposed to the low-income countries.
• The adverse events lead to significant disability-adjusted life years as well as premature deaths, especially in the areas of falls in the hospital, venous thromboembolisms and pressure ulcers.

The consequences of these facts in terms of cost (both direct and indirect) and productivity lost are imagined to be monumental. They add further urgency to the need to improve health care delivery and find alternatives to hospitalizations whenever possible, as the burden with increasing populations and crises worldwide can only be expected to increase. The demand for further interventions, reform and overhaul in recent years has never been greater.

Reference

1. Jha AK, Larizoglitia I, Audera-Lopez C, Prasopia-Plazier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modeling of observational studies. BMC Quality & Safety, 2013;22:809-815.