Evans Sue M, Berry Jesia G, Smith Brian J, Esterman Adrian J
Department of Medicine, University of Adelaide, Adelaide, South Australia.
BMC Public Health. 2006 Feb 22;6:41. doi: 10.1186/1471-2458-6-41.
Studies investigating adverse events have traditionally been principally undertaken from a medical perspective. The impact that experience of an adverse event has on consumer confidence in health care is largely unknown. The objectives of the study were to seek public opinion on 1) the rate and severity of adverse events experienced in hospitals; and 2) the perception of safety in hospitals, so that predictors of lack of safety could be identified.
A multistage, clustered survey of persons residing in South Australia (2001), using household interviews (weighted n = 2,884).
A total of 67% of respondents aged over forty years reported having at least one member of their household hospitalised in the past five years; with the average being two hospital admissions in five years. Respondents stated that 7.0% (95%CI: 6.2% to 7.9%) of those hospital admissions were associated with an adverse event; 59.7% of respondents (95% CI: 51.4% to 67.5%) rated the adverse event as really serious and 48.5% (95% CI: 40.4% to 56.8%) stated prolonged hospitalisation was required as a consequence of the adverse event. Perception of safety in hospitals was largely affected by the experience of an adverse event; really serious events were the most significant predictor of lack of safety in those aged 40 years and over (RR 2.38; p<0.001).
The experience of adverse events negatively impacted on public confidence in hospitals. The consumer-reported adverse event rate in hospitals (7.0%) is similar to that identified using medical record review. Based on estimates from other studies, self-reported claims of adverse events in hospital by consumers appear credible, and should be considered when developing appropriate treatment regimes.
传统上，对不良事件的研究主要是从医学角度进行的。不良事件经历对消费者医疗保健信心的影响在很大程度上尚不清楚。本研究的目的是就以下方面征求公众意见：1）医院中不良事件的发生率和严重程度；2）对医院安全性的认知，以便确定缺乏安全性的预测因素。
2001年对居住在南澳大利亚的人员进行了多阶段整群调查，采用入户访谈（加权样本量n = 2,884）。
共有67%的40岁以上受访者报告称，在过去五年中其家庭中至少有一名成员住院；平均每人五年内住院两次。受访者表示，这些住院中有7.0%（95%置信区间：6.2%至7.9%）与不良事件相关；59.7%的受访者（95%置信区间：51.4%至67.5%）将不良事件评为非常严重，48.5%（95%置信区间：40.4%至56.8%）表示不良事件导致住院时间延长。对医院安全性的认知在很大程度上受到不良事件经历的影响；非常严重的事件是40岁及以上人群缺乏安全性的最显著预测因素（相对风险2.38；p<0.001）。
不良事件经历对公众对医院的信心产生了负面影响。消费者报告的医院不良事件发生率（7.0%）与通过病历审查确定的发生率相似。根据其他研究的估计，消费者自我报告的医院不良事件索赔似乎可信，在制定适当的治疗方案时应予以考虑。
