Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I.

@article{Brennan1991IncidenceOA,
  title={Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I.},
  author={Troyen A. Brennan and Lucian Leape and N M Laird and L Hebert and A. Russell Localio and Ann G. Lawthers and J P Newhouse and Paul Cronin Weiler and Howard H. Hiatt},
  journal={The New England journal of medicine},
  year={1991},
  volume={324 6},
  pages={
          370-6
        }
}
BACKGROUND As part of an interdisciplinary study of medical injury and malpractice litigation, we estimated the incidence of adverse events, defined as injuries caused by medical management, and of the subgroup of such injuries that resulted from negligent or substandard care. METHODS We reviewed 30,121 randomly selected records from 51 randomly selected acute care, nonpsychiatric hospitals in New York State in 1984. We then developed population estimates of injuries and computed rates… 

Figures and Tables from this paper

The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II.
TLDR
The high proportion that are due to management errors suggests that many others are potentially preventable now, and reducing the incidence of these events will require identifying their causes and developing methods to prevent error or reduce its effects.
Relation between malpractice claims and adverse events due to negligence. Results of the Harvard Medical Practice Study III.
TLDR
Medical-malpractice litigation infrequently compensates patients injured by medical negligence and rarely identifies, and holds providers accountable for, substandard care.
Cost of medical injury in New Zealand: A retrospective cohort study
TLDR
The results suggest that substantial resources could be saved by eliminating preventable adverse events and suggest that older patients, neonates and those with moderately serious co-morbidity tended to have more costly adverse events.
Costs of medical injuries in Utah and Colorado.
TLDR
The costs of adverse events were similar to the national costs of caring for people with HIV/AIDS, and totaled 4.8% of per capita health care expenditures in these states.
Exploring the Causes of Adverse Events in NHS Hospital Practice
TLDR
The underlying causes of errors in clinical practice are examined, rather than identifying specific errors made by individuals, to look at possible faults in the organization of care.
The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada
TLDR
The overall incidence rate of AEs of 7.5% in this study suggests that, of the almost 2.5 million annual hospital admissions in Canada similar to the type studied, about 185 000 are associated with an AE and close to 70 000 of these are potentially preventable.
Adverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study
TLDR
The incidence of AEs, preventable AEs and potentially preventable deaths in the Netherlands is substantial and needs to be reduced and patient safety efforts should focus on surgical procedures and older patients.
Epidemiology and prevention of unexpected in-hospital deaths.
The incidence of adverse events in Swedish hospitals: a retrospective medical record review study
TLDR
This study confirms that preventable adverse events were common, and that they caused extensive human suffering and consumed a significant amount of the available hospital resources.
Adverse events and comparison of systematic and voluntary reporting from a paediatric intensive care unit
TLDR
While the two methods both capture some events, systematic reporting captures serious events, while voluntary reporting captures mainly insignificant and minor events.
...
...

References

SHOWING 1-10 OF 32 REFERENCES
The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II.
TLDR
The high proportion that are due to management errors suggests that many others are potentially preventable now, and reducing the incidence of these events will require identifying their causes and developing methods to prevent error or reduce its effects.
Identification of adverse events occurring during hospitalization. A cross-sectional study of litigation, quality assurance, and medical records at two teaching hospitals.
TLDR
The majority of adverse events and episodes of negligent care are discoverable with the methods used to evaluate medical records, and the adverse events the authors failed to discover led to less costly malpractice claims.
The high cost of low-frequency events: the anatomy and economics of surgical mishaps.
TLDR
A one-year prospective survey to identify adverse outcomes due to error during care in the field of general surgery found 36 cases among 5612 surgical admissions to the Peter Bent Brigham Hospital; in 23 cases the initiating mishap had occurred in another hospital before transfer.
Reliability and Validity of Judgments Concerning Adverse Events Suffered by Hospitalized Patients
TLDR
It was found that a two-step review process of medical records can produce judgments about adverse events that are both reliable and valid, and cases classified as difficult to judge from causation were judged less reliable.
Iatrogenic illness on a general medical service at a university hospital.
TLDR
Given the increasing number and complexity of diagnostic procedures and therapeutic agents, monitoring of untoward events is essential, and attention should be paid to educational efforts to reduce the risks of iatrogenic illness.
Just Doctoring: Medical Ethics in the Liberal State
TLDR
Troyen Brennan offers clinical examples of many of today's most challenging medical problems from informed consent to care rationing and the repercussions of the HIV epidemic and gives his recommendation for a new ethical perspective.
Modern Tort Law and Its Reform
In 1960, progressive members of the state judiciary, joined later by the American Law Institute, commenced upon a revolution in the conceptual basis of tort law of a dimension previously unknown in
A study of medical injury and medical malpractice.
TLDR
For nearly two decades, an atmosphere of crisis has enveloped the authors' system of medical-malpractice litigation and liability insurance, and legislators have responded to the problems of a shrinking insurance market and rising insurance costs by restricting liability and, in some cases, limiting damages.
An overview of medical malpractice legislation.
  • D. Siegel
  • Medicine
    New York state journal of medicine
  • 1986
...
...