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瑞士患者报告的医疗和用药错误的频率及预测因素。

Frequency of and predictors for patient-reported medical and medication errors in Switzerland.

机构信息

Swiss Patient Safety Foundation, Zürich, CH.

出版信息

Swiss Med Wkly. 2011 Oct 4;141:w13262. doi: 10.4414/smw.2011.13262. eCollection 2011.

Abstract

OBJECTIVES

To analyse the frequency of and identify risk factors for patient-reported medical errors in Switzerland. The joint effect of risk factors on error-reporting probability was modelled for hypothetical patients.

METHODS

A representative population sample of Swiss citizens (n = 1306) was surveyed as part of the Commonwealth Fund's 2010 lnternational Survey of the General Public's Views of their Health Care System's Performance in Eleven Countries. Data on personal background, utilisation of health care, coordination of care problems and reported errors were assessed. Logistic regression analysis was conducted to identify risk factors for patients' reports of medical mistakes and medication errors.

RESULTS

11.4% of participants reported at least one error in their care in the previous two years (8% medical errors, 5.3% medication errors). Poor coordination of care experiences was frequent. 7.8% experienced that test results or medical records were not available, 17.2% received conflicting information from care providers and 11.5% reported that tests were ordered although they had been done before. Age (OR = 0.98, p = 0.014), poor health (OR = 2.95, p = 0.007), utilisation of emergency care (OR = 2.45, p = 0.003), inpatient-stay (OR = 2.31, p = 0.010) and poor care coordination (OR = 5.43, p <0.001) are important predictors for reporting error. For high utilisers of care that unify multiple risk factors the probability that errors are reported rises up to p = 0.8.

CONCLUSIONS

Patient safety remains a major challenge for the Swiss health care system. Despite the health related and economic burden associated with it, the widespread experience of medical error in some subpopulations also has the potential to erode trust in the health care system as a whole.

摘要

目的

分析瑞士患者报告医疗错误的频率,并确定其相关风险因素。针对假设患者,对风险因素对错误报告概率的联合影响进行建模。

方法

作为联邦基金 2010 年对 11 个国家公众对其医疗保健系统绩效的看法的国际调查的一部分,对瑞士公民的代表性人群样本(n=1306)进行了调查。评估了个人背景、医疗保健利用情况、护理协调问题和报告的错误等数据。采用逻辑回归分析确定患者报告医疗失误和药物错误的风险因素。

结果

在过去两年中,11.4%的参与者报告了至少一次护理失误(8%为医疗错误,5.3%为药物错误)。护理协调不良的经历较为频繁。7.8%的人经历过无法获取检查结果或医疗记录,17.2%的人收到过来自护理提供者的相互矛盾的信息,11.5%的人报告说尽管之前已经做过检查,但仍开了新的检查。年龄(OR=0.98,p=0.014)、健康状况较差(OR=2.95,p=0.007)、急诊使用(OR=2.45,p=0.003)、住院(OR=2.31,p=0.010)和护理协调不良(OR=5.43,p<0.001)是报告错误的重要预测因素。对于高度利用医疗保健的患者,同时具有多种风险因素的情况下,错误报告的概率高达 p=0.8。

结论

患者安全仍然是瑞士医疗保健系统面临的主要挑战。尽管与健康相关的和经济负担相关,但在某些亚人群中广泛存在的医疗错误体验也有可能侵蚀对整个医疗保健系统的信任。

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