High rate of medical errors in developing countries

Patients in hospitals in the developing world may face an unrecorded toll of healthcare related harm, researchers warned today.

Dr Ross Wilson of the New York City Health and Hospital Corporation, USA, and colleagues looked at the rate of adverse events among 15,548 patients at 26 hospitals in eight developing countries – Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen.

Adverse events were defined as unintended injury resulting in temporary or permanent disability or death, and which was associated with healthcare management rather than the underlying disease.

The overall rate of adverse events was eight per cent, ranging from three to eighteen per cent between countries. About 30 per cent resulted in death. The majority (83 per cent) were judged to be preventable.

About 34 per cent were due to errors in "relatively non-complex clinical situations", report the authors in their study published by the British Medical Journal.

"Inadequate training and supervision of clinical staff or the failure to follow policies or protocols contributed to most events," they write.

The authors conclude: "Unsafe patient care represents a serious and considerable danger to patients in the hospitals that were studied, and hence should be a high priority public health problem. Many other developing and transitional economies will probably share similar rates of harm and similar contributory factors."

They add that their results "should stimulate and facilitate the urgent institution of appropriate remedial action and also to trigger more research". Ultimately, prevention of adverse events requires improving basic clinical processes, rather than simply providing more resources, they believe.

Patient Safety in Developing Countries: Retrospectively estimating the scale and nature of harm to hospitalised patients. Wilson, R. M. et al. The British Medical Journal March 4 2012 doi: 10.1136/bmj.e832