| Title | Adverse events among medical patients after discharge from hospital. | | Author(s) | Forster AJ, Clark HD, Menard A, Dupuis N, Chernish R, Chandok N, Khan A, van Walraven C | | Institution | Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada. aforster@ohri.ca | | Source | CMAJ 2004 Feb 3; 170(3):345-9. | | MeSH | Adverse Drug Reaction Reporting Systems
Aged
Aged, 80 and over
Canada
Cross Infection
Female
Hospitals, Teaching
Humans
Male
Medical Errors
Middle Aged
Outcome Assessment (Health Care)
Patient Discharge
Prospective Studies
Quality Assurance, Health Care
Research Support, Non-U.S. Gov't
| | Abstract | BACKGROUND: Adverse events (AEs) are adverse outcomes caused by medical care. Several studies have indicated that a substantial number of patients experience AEs before or during hospitalization. However, few data describe AEs after hospital discharge. We determined the incidence, severity, preventability and ameliorability of AEs in patients discharged from the general internal medicine service of a Canadian hospital.
METHODS: At a multisite Canadian teaching hospital, we prospectively studied patients who were consecutively discharged home or to a seniors' residence from the general internal medicine service during a 14-week interval in 2002. We used telephone interview and chart review to identify outcomes after discharge. Two physicians independently reviewed each outcome to determine if the patient experienced an AE. The severity, preventability and ameliorability of all AEs were classified.
RESULTS: During the study period, outcomes were determined for 328 of the 361 eligible patients, who averaged 71 years of age (interquartile range 54-81 years). After discharge, 76 of the 328 patients experienced at least 1 AE (overall incidence 23%, 95% confidence interval [CI] 19%-28%). The AE severity ranged from symptoms only (68% of the AEs) or symptoms associated with a nonpermanent disability (25%) to permanent disability (3%) or death (3%). The most common AEs were adverse drug events (72%), therapeutic errors (16%) and nosocomial infections (11%). Of the 76 patients, 38 had an AE that was either preventable or ameliorable (overall incidence 12%, 95% CI 9%-16%).
INTERPRETATION: Approximately one-quarter of patients in our study had an AE after hospital discharge, and half of the AEs were preventable or ameliorable. | | Language | eng | | Pub Type(s) | Journal Article
Multicenter Study
| | PubMed ID | 14757670 |
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