Abstract

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. 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. 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. 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.

Highlights

  • Adverse events and medical errors cause considerable harm

  • 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 has the potential to erode trust in the health care system as a whole

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Summary

Introduction

Adverse events and medical errors cause considerable harm. Initially, to patients and to health care professionals involved in errors (“second victims”) [1,2,3]. In a recent survey of Swiss cancer patients, 16% reported having experienced an error in their care and 11% were currently very concerned about errors [8] These studies concentrate on single episodes of hospital care. As patients are the only individuals physically present during every treatment and consultation, they carry with them important contextualised information in particular with relation to transition between different settings [14, 15] Surveying patients about their experience of medical error across the specific types of health care consumed, e.g. hospital care, can help to identify risk factors for error along the care continuum, and relative to specific patientlevel factors and the amount and type of health care utilised. The main objective of this study was an analysis of the frequency and

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