More than 43 million people worldwide are injured each year due to unsafe medical care, according to a study, and these injuries result in the loss of nearly 23 million years of healthy life.
The findings, reported Sept. 18 on the website of BMJ Quality & Safety, represent a major new effort to calculate the global burden of unsafe medical care across a range of adverse health events.
"This is the first attempt to quantify the human suffering that results from unsafe care" Ashish Jha, MD, MPH, the study's lead author and a professor of health policy and management at the Harvard School of Public Health in Boston, said in a news release. "We find that millions of people around the world are hurt, disabled and sometimes even die as a result of medical errors."
Researchers with HSPH, the Patient Safety Programme of the World Health Organization in Geneva, Switzerland, and the Health Care Quality and Outcomes Program at RTI International in Durham, N.C., used data from more than 4,000 articles that have been published over the previous few decades and were focused on adverse events in hospitals, as well as from epidemiologic studies commissioned by the WHO to estimate how much these events harmed patients.
The researchers examined seven adverse outcomes that can occur while patients are hospitalized: injuries due to medications, catheter-related urinary tract infections, catheter-related bloodstream infections, hospital-acquired pneumonia, deep vein thrombosis, falls and pressure ulcers.
The authors used the existing data to model the impact of these adverse events on hospitalized patients across the globe. The researchers used a metric called "disability-adjusted life years," which measures years of healthy life lost due to ill health, disability or early death.
Key findings
For most of the adverse events examined in the study, premature death was the biggest driver of disability-adjusted life years lost 78.6% of all adverse events in high-income countries and 80.7% in low- and middle-income countries.
Overall, however, disability was more common than death.
For every 100 hospitalizations, there were approximately 14.2 adverse events in high-income countries and 12.7 in low- and middle-income countries. But the number of disability-adjusted life years lost was more than twice as high in low- and middle-income countries (15.5 million) as in high-income countries (7.2 million).
The most common adverse event in high-income countries was injuries due to medications (incidence rate 5%). The most common adverse event in low- and middle-income countries was deep vein thrombosis (incidence rate 3%).
The authors noted that, taken together, the seven types of adverse impacts examined in the study rank as the 20th leading cause of morbidity and mortality for the world's population. Many other types of adverse events not examined in this study "such as the use of infected needles, tainted blood products or counterfeit drugs" likely would raise the estimates of disability-adjusted life years lost substantially.
The researchers also found that about two-thirds of injuries and harm occur in low- and middle-income countries.
The findings suggest that policymakers and nations should place major emphasis on not only improving access to care but also on ensuring the safety and effectiveness of healthcare systems worldwide, according to the authors.
"When patients are sick, we find that they are too often injured from the care that is meant to heal them," Jha said. "This should not be seen as a price of providing healthcare. We can and should do so much better."
Study: http://qualitysafety.bmj.com/content/22/10/809.full.
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