Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults.
Approach to Improving Safety
- Diagnostic Errors
- Discontinuities, Gaps, and Hand-Off Problems
- Medication Safety
- Medical Complications
Setting of Care
Improving patient safety in the ambulatory setting requires the development of new care models, greater utilization of information technology, and a focus on patient factors such as health literacy. Current health policy reform often debates the virtues of international care delivery models as a driver for change. Building on past Commonwealth Fund reports, this study surveyed patients with self-reported chronic disease in eight countries to identify risk factors associated with self-reported errors. Investigators found that errors were associated with a number of factors, including a patient's age, education level, and prescription drug use. The three risk factors with the greatest relationship to errors were experiencing a care coordination problem, having seen four or more doctors within the past 2 years, and having used the emergency department in the last 2 years. The authors advocate for improved sharing of clinical information (e.g., electronic health records) and specific policy and practices designed to improve care coordination.