Unsafe medical care harms more than 43 million people across the world, resulting in a loss of almost 23 million years of “healthy” life, researchers claim today.
In the first study of its kind to try to quantify human suffering that results from unsafe care, Harvard School of Public Health, Boston, MA, USA, said their findings should force policymakers and nations into not just improving access to care but also on ensuring the safety and effectiveness of health care systems.
Researcher Professor Ashish Jha said: “We find that millions of people around the world are hurt, disabled, and sometimes even die as a result of medical errors.”
The study, which appears online on BMJ Quality & Safety, used data from more than 4,000 articles that have been published over the previous few decades which focus on adverse events in hospitals, as well as from epidemiologic studies commissioned by World Health Organisation.
The researchers examined injuries due to medication; catheter-related urinary tract infections; catheter-related blood stream infections; hospital-acquired pneumonia; blood clots in veins; falls; and bedsores.
Using a metric called "disability-adjusted life years" (DALYs), which measures years of healthy life lost due to ill health, disability, or early death, they used the data to model the impact of these problems on hospital patients across the globe.
Premature death accounted for most DALYs lost, with 78.6% of all adverse events in high-income countries and 80.7% in low- and middle-income countries. However, disability was more common than death itself, the study found.
For every 100 hospitalisations, there were about 14.2 adverse events in high-income countries and 12.7 in low- and middle-income countries, while the number of DALYs lost was more than twice as high in low- and middle-income countries (15.5 million) as it was in high-income countries (7.2 million).
Researchers also found that the most common adverse events in high-income countries were drug-related mistakes, with an incident rate of 5%, while in low- and middle-income countries blood clots in veins were the most common problem, with a 3% rate.
The authors pointed out that other mistakes, such as the use of infected needles, tainted blood products, or counterfeit drugs, were not examined in this study.
“When patients are sick, we find that they are too often injured from the care that is meant to heal them. This should not be seen as a price of providing health care—we can and should do so much better,” said Prof Jha.
Jha A, Larizgoitia I et al. The global burden of unsafe medical care: an observational study. BMJ Quality & Safety. 18 September 2013, 22:809-815.
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