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Self-Reported Medical Errors in Seven Countries: Implications for Canada

A key component of improving patient safety is preventing and managing medical errors. In Canada, such errors, also called "adverse events," account for 5.4 percent of the total number of days patients spend in the hospital. In a study using data from the Commonwealth Fund 2007 International Health Policy Survey in Seven Countries, researchers—including former Canadian Harkness Associate Neil J. MacKinnon—compared the rate of self-reported errors in Canada with other countries.

Overall, the percentage of respondents who reported having experienced at least one medical error was substantial, ranging from a low of 12 percent in Germany to a high of 20 percent in Australia and the United States. Canadians had the third highest rate at 17 percent. The authors also identified risk factors associated with reporting a medical error: having a chronic illness, patients reporting not spending enough time with their physicians, patients under age 65, use of four or more medications, a lack of personal involvement in care, insufficient nurse staffing, and the absence of a regular physician.

Based on their results, the authors make two recommendations for clinicians and policymakers. First, when a patient comes to a physician's office, the physician should assess for the identified risk factors. Second, health care organizations and individual clinicians should strive to encourage patients' involvement in their own care. A lack of involvement in decision-making was the risk factor most associated with self-reported medical errors, the authors said.

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J. O'Hagan, N. J. MacKinnon, D. Persaud et al., "Self-Reported Medical Errors in Seven Countries: Implications for Canada," Healthcare Quarterly, 2009 12(Spec. Iss.):55–61.