Studies Analyze Prevalence of Medical Adverse Events and Negligence During Hospitalization
For immediate release: March 01, 2000
Boston, MA--In two separate studies examining medical adverse events, which occur during hospitalization, researchers at Brigham and Women's Hospital (BWH) and Harvard School of Public Health (HSPH) have found that such events are prevalent and pose a significant health problem, yet no correlation between negligent care and malpractice claims appears to exist. Both studies are published in the March issue of Medical Care, a journal of the American Public Health Association.
BWH and HSPH researchers examined medical adverse events that occurred in hospitals throughout Utah and Colorado in 1992 as a follow-up to similar study conducted in New York in 1984 Harvard Medical Practice Study, which was conducted in New York.
"Our studies were designed to determine if the medical adverse event findings in New York held true in different states and time periods, and to gather data to help focus future research to prevent such events," said senior author Troyen Brennan, MD, JD, MPH, of Brigham and Women's Hospital and Harvard School of Public Health.
Incidence of Adverse Events
In the first study, researchers found medical adverse events to be prevalent among the study group in Utah and Colorado. Also, the data indicated a needed improvement in systems of surgical care and drug delivery to substantially reduce the burden of medical errors.
Specifically, researchers reviewed a sample of 15,000 medical records from 28 hospitals. Adverse events occurred in 2.9 per cent of hospitalizations in each state. In Utah, 32.6 per cent of adverse events were due to negligence and in Colorado, 27.4 per cent. Errors made in the operating room comprised 44.9 per cent of all adverse events.
"Our findings in Utah and Colorado echo what was formerly found in New York--medical errors are a significant health problem," said lead author Eric Thomas, MD, MPH, formerly of BWH. "To improve patient safety, health care institutions should utilize opportunities to reduce the occurrence of preventable medical adverse events."
Negligent Care and Malpractice Claims
In the second study, researchers sought to better understand the relationship between negligent care and malpractice lawsuits in the United States. The findings suggest that negligent adverse events occur much more frequently than malpractice claims; however, physicians were more likely to be sued for rendering non-negligent care.
Researchers compared 14,700 medical records to malpractice claims filed in Utah and Colorado. The goals were to calculate how frequently negligent and non-negligent management of patients in both states led to malpractice claims, and to understand the characteristics of victims of negligent care, who did not or could not obtain compensation for their injuries from the medical malpractice system.
Less than one quarter of the patients who filed a malpractice claim were found to have suffered injuries caused by negligence. On the other hand, of the patients who did suffer negligent injury, 97 per cent did not sue. Compared with patients who did sue for negligence occurring in 1992, those who did not sue were more likely to be Medicare or Medicaid recipients, 75 years of age or older or low-income earners. In addition, patients who did not sue were more likely to suffer a minor disability as a result of their injury.
"The weak correlation between medical negligence and malpractice claims that was present in New York in 1984 was also present in Utah and Colorado in 1992," said David Studdert, LLB, ScD, MPH, formerly of BWH and lead author of the study.
According to Dr. Studdert, the elderly and the poor were more likely to suffer negligence and not sue, probably because their low-income status restricted their ability to secure legal representation.
The Robert Wood Johnson Foundation in Princeton, New Jersey provided funding for both studies.
For further information, please contact:
Director of Communications
677 Huntington Avenue
Boston, Massachusetts 02115
Maggie Hayden, Brigham and Women's Hospital, (617) 732-5008
Tricia Oliver, Brigham and Women's Hospital, (617) 732-5008
Robert Hutchison, Brigham and Women's Hospital, (617) 732-5008