More patients are harmed by medical errors stemming from care received in physicians? offices than in hospitals, a new study concludes.
The research by the Robert Graham Center in Washington, D.C., was published in the April edition of the peer-reviewed journal, Quality and Safety in Health Care.
In the study, "Learning from Malpractice Claims about Negligent, Adverse Events in Primary Care in the United States," Graham Center researchers looked at 5,921 malpractice claims that could be identified as errors that occurred in the primary care settled between 1985 and 2000.
In a prepared statement, Robert L. Phillips, Jr., M.D., lead author and assistant director of the Graham Center, said the research "shows the actual location where people are being harmed and that's in the outpatient setting more often than in hospitals. The overwhelming majority of health care in the United States is delivered outside of hospitals and we cannot assume that medical errors in outpatient settings are less harmful than those in hospitals."
Of the errors found in the claims, 68% percent were for negligent events in outpatient settings. They resulted in more than 1,200 deaths.
Last year, the Center for Information Technology Leadership in Boston released a study with somewhat similar dire results concerning errors in the outpatient setting. That group, an affiliate of Partners Health Care, concluded ambulatory physician order entry systems could prevent 2 million adverse drug events and 130,000 life-threatening conditions each year.
The Graham Center report concludes that, on a per capita basis, severe outcomes from negligent, adverse events were more likely occur in hospitals, but, due to the higher volumes in outpatient settings, the number of cases involving high severity outcomes and death was larger in the outpatient setting.
Diagnostic error figured in more than one-third of the claims.
"The category 'diagnostic error' doesn't give us enough information to fix the problems," Phillips said. "For example, it doesn't tell us whether the wrong diagnoses resulted from a lab report that did not reach the physician or if a piece of information was placed in the wrong medical file or if the physician made an erroneous decision that could have been avoided with better training."
Of the 10 most common medical conditions with error-related claims, no one condition accounted for more than 5% percent of all negligent claims and in total all 10 amounted to just 20% of all claims. The top 10 were acute myocardial infarction, lung cancer, breast cancer, colon cancer, brain damage in an infant, appendicitis, meningitis, pulmonary embolism, diabetes, and symptoms involving abdomen and pelvis.