Psychiatry, Aalborg University Hospital, Aalborg 9000, Denmark.
Danish Center for Health Services Research, Aalborg University, Aalborg 9220, Denmark.
Int J Qual Health Care. 2024 Jun 13;36(2). doi: 10.1093/intqhc/mzae049.
The 2020 onset of the COVID-19 pandemic globally strained healthcare. Healthcare systems worldwide had to rapidly reorganize, impacting service delivery, patient care, and care-seeking behaviors. This left little time to assess the pandemic's effects on patient safety. This paper investigates COVID-19's influence on patient safety in a Danish region, using data from the national reporting system for adverse events during the initial COVID-19 surge in early 2020. This retrospective analysis investigated how the early phase of the COVID-19 pandemic (January-September 2020) affected the incidence of adverse events in a Danish Region, comparing it to the same period in 2019. Data were sourced from the Danish Patient Safety Database and regional systems. Adverse events were reported numerically. Descriptive statistics were employed to describe the percentage difference in adverse events and hospital activity, as well as the rate of adverse events per 1000 activities. Additionally, COVID-19-specific adverse events from April 2020 to March 2021 were identified and analyzed, categorizing them into seven risk areas across various healthcare sectors. During Denmark's initial COVID-19 surge in early 2020, the North Denmark Region's hospitals reported a significant decrease in adverse events, with a 42.5% drop in March 2020 compared to March 2019. From January to September 2020, the number of adverse events dropped 8.5% compared to the same period in 2019. In the same period, hospital activity declined by 10.2%. The ratio of reported adverse events per 1000 hospital activities thus decreased in early 2020 but showed only a minor difference overall for January-September compared to 2019. Between April 2020 and March 2021, out of 5703 total adverse events, 324 (5.7%) were COVID-19 related. COVID-19-related events were categorized into seven distinct risk areas, reflecting diverse impacts across healthcare sectors including hospitals, general practices, pre-hospital care, and specialized services. The initial decline in reporting of adverse events likely resulted from rapid healthcare changes and under-prioritization of the reporting system during the acute phase. However, a near return to pre-pandemic reporting levels suggests a resilient reporting system despite the crisis. The study's strength lies in the comprehensive data from Danish reporting systems, though it acknowledges potential underreporting and doesn't measure the pandemic's overall impact on patient safety.
2020 年新冠疫情在全球范围内对医疗保健造成了严重影响。全球医疗保健系统不得不迅速进行重组，这影响了服务的提供、患者的护理和就医行为。这使得几乎没有时间评估大流行对患者安全的影响。本文使用 2020 年初新冠疫情初期全国不良事件报告系统的数据，研究了丹麦某地区新冠疫情对患者安全的影响。这是一项回顾性分析，比较了丹麦某地区 2020 年 1 月至 9 月（新冠疫情早期阶段）与 2019 年同期不良事件的发生率。数据来源于丹麦患者安全数据库和地区系统。不良事件以数字形式报告。采用描述性统计方法描述不良事件和医院活动的百分比差异，以及每 1000 次活动的不良事件发生率。此外，还确定并分析了 2020 年 4 月至 2021 年 3 月期间的新冠特定不良事件，将其分为七个不同的风险领域，涵盖了各个医疗保健领域。2020 年初丹麦新冠疫情初期，北丹麦地区医院报告的不良事件显著减少，2020 年 3 月与 2019 年 3 月相比下降了 42.5%。2020 年 1 月至 9 月，不良事件数量比 2019 年同期下降了 8.5%。同期，医院活动减少了 10.2%。因此，2020 年初报告的不良事件每 1000 次医院活动的比例下降，但与 2019 年同期相比，1 月至 9 月总体差异较小。2020 年 4 月至 2021 年 3 月，在总共 5703 例不良事件中，有 324 例（5.7%）与新冠相关。新冠相关事件分为七个不同的风险领域，反映了医院、全科医生、院前护理和专科服务等医疗保健部门的不同影响。不良事件报告的最初减少可能是由于急性阶段医疗保健的快速变化和报告系统的优先级较低。然而，尽管面临危机，但报告系统几乎恢复到大流行前的报告水平，这表明报告系统具有弹性。该研究的优势在于其使用了丹麦报告系统的全面数据，但也承认可能存在漏报，且未衡量大流行对患者安全的总体影响。
