Zegers Marieke, de Bruijne Martine C, Wagner Cordula, Groenewegen Peter P, Waaijman Roelof, van der Wal Gerrit
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands.
BMC Health Serv Res. 2007 Feb 25;7:27. doi: 10.1186/1472-6963-7-27.
Various international studies have shown that a substantial number of patients suffer from injuries or even die as a result of care delivered in hospitals. The occurrence of injuries among patients caused by health care management in Dutch hospitals has never been studied systematically. Therefore, an epidemiological study was initiated to determine the incidence, type and impact of adverse events among discharged and deceased patients in Dutch hospitals.
METHODS/DESIGN: Three stage retrospective patient record review study in 21 hospitals of 8400 patient records of discharged or deceased patients in 2004. The records were reviewed by trained nurses and physicians between August 2005 and October 2006. In addition to the determination of presence, the degree of preventability, and causes of adverse events, also location, timing, classification, and most responsible specialty of the adverse events were measured. Moreover, patient and admission characteristics and the quality of the patient records were recorded.
In this paper we report on the design of the retrospective patient record study on the occurrence of adverse events in Dutch hospitals. Attention is paid to the strengths and limitations of the study design. Furthermore, alterations made in the original research protocol in comparison with former international studies are described in detail.
多项国际研究表明，相当数量的患者在医院接受治疗时受到伤害甚至死亡。荷兰医院因医疗管理导致患者受伤的情况从未得到系统研究。因此，开展了一项流行病学研究，以确定荷兰医院出院患者和死亡患者中不良事件的发生率、类型及影响。
方法/设计：对21家医院2004年8400份出院或死亡患者的病历进行三阶段回顾性研究。2005年8月至2006年10月期间，由经过培训的护士和医生对病历进行审查。除了确定不良事件的存在、可预防性程度和原因外，还对不良事件的发生地点、时间、分类以及最相关的专业进行了评估。此外，记录了患者和入院特征以及病历质量。
本文报告了荷兰医院不良事件发生情况的回顾性病历研究设计。关注了研究设计的优点和局限性。此外，还详细描述了与以往国际研究相比，原始研究方案所做的改动。
