Healthy Skepticism Library item: 434

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Publication type: news

Nearly a Quarter of Canadians Report a Preventable Adverse Event in Own Care or That of a Family Member: Fifth annual report showcases advances in patient safety and key health trends
The Canadian Institute for Health Information 2004 Jun 9

Full text:

A new report released today by the Canadian Institute for Health Information (CIHI) shows that nearly a quarter of Canadian adults
(5.2 million people) report that they, or a member of their family, have experienced a preventable adverse event. The report Health Care in Canada
2004 is CIHI’s fifth annual publication on the state of the health care system.

“The recent publication of the Canadian Adverse Events Study showed us that more than one million additional hospital days could be attributed to adverse events. Clearly, we pay a high price on both a human level and as a health system,” says CIHI’s Board Chair Graham W. S. Scott, Q.C. “New technology, innovation and a more open reporting system for adverse events will help ensure that Canadians can continue to have confidence in their health system.”

CIHI’s report also compares, for the first time, how often Canadians experience several different types of adverse events, including being given the wrong medication or the wrong dose, contracting a hospital-acquired infection, experiencing birth trauma, or having a foreign object (such as a
sponge) left in them after a procedure. Some types of events, such as HIV-infected blood transfusions are very rare (research estimates the risk at about one per 10 million units of blood). Others are more common: one in
9 adults with health problems reported receiving wrong medication or the wrong dose by a doctor, hospital, or pharmacist in the past two years; one in 9 adults or one in 11 children contracted an infection (such as pneumonia or a urinary tract infection) while in hospital.

This year, CIHI reports on its first national patient safety indicators.
These indicators include:

• Foreign objects (e.g. a sponge or instrument) left in after a procedure Between 2000-2001 and 2002-2003, an estimated one in every 6,667 surgical/medical patients had a foreign object accidentally left in them following a procedure.

• Post-operative hip fracture
  Between 2000-2001 and 2002-2003, one inpatient sustained a hip fracture for every 1,124 surgical and medical hospitalizations among seniors.

• Birth trauma
  Birth trauma (injury) occurs in about 11.6 of every 1,000 hospital births, or one birth trauma per 81 newborns.

Key highlights from CIHI’s Health Care in Canada 2004’s patient safety chapters include:

In Canada, researchers Ross Baker and Peter Norton recently found that, in 2000-2001, adverse events occurred in 7.5% of medical/surgical admissions in non-specialized acute care hospitals. Expert reviewers considered 37% of those adverse events to be “highly preventable.”

• Experts say that under-reporting makes reducing the incidence of adverse events more challenging. In a 2003 survey, more than 70% of Canadian health professionals said that under-reporting of adverse drug reactions was a very or somewhat serious problem.

• About two-thirds of Canadians (67%) think that more litigation could result in physician shortages in some high-risk specialties, although an even greater number (76%) believe that the threat of litigation may help ensure quality care. According to the Canadian Medical Protective Association, malpractice claims in Canada have stabilized in recent years, and now range from 1.7 to 2.5 claims per 100 physicians annually.

The report also highlights examples of safe care strategies that have proven successful, such as using electronic tools to prevent medication errors and implementing procedures to reduce chance of wrong-side surgeries.

OTHER FINDINGS-HEALTH CARE 2004

As in previous years, CIHI’s health report also presents new information on other topics related to the delivery of health care in Canada: health human resources, health expenditures, wait times, and regional trend information on caesarean sections, mortality rates after a heart attack, and readmission rates for asthma and pneumonia. Some of the key highlights include:

• Fewer people are staying overnight in hospitals (down from 3.6 million in
  1985-1986 to 2.9 million in 2000-2001) but day surgery is much more common, accounting for more than half (50.6%) of inpatient and day surgery hospitalizations in 2001-2002.

• Low-income Canadians were more likely than other Canadians to have stayed overnight in a hospital in the past year, about as likely to have visited a doctor, and less likely to have consulted a dentist.

• In 2002-2003, 71 facilities in six provinces tracked wait times for rehabilitation services. Overall, four in 10 patients (42%) were admitted on the day they were referred. About half (52%) of those referred by inpatient and rehabilitation units of the same facility waited one day for care.
  Median wait times ranged from two to 12 days for other patients who were referred by residential care facilities, private practices, other rehabilitation facilities, ambulatory care services and other sources.

• The average age of the health workforce is increasing. Between the 1991 and 2001 censuses, the proportion of the working population aged 45 to 64 increased. This trend is more pronounced for people in health occupations than for those in the workforce as a whole.

• In 2003, Canada spent a forecast $121.4 billion on health care, or an average of $3,839 per person.

• Overall heart attack and stroke outcomes-among the leading cause of death in Canada-are improving slightly, but substantial differences continue to exist across the country. Between 1999-2000 and 2001-2002, 11.8% of patients hospitalized for an acute myocardial infarction (AMI) died in hospital within 30 days, while the proportion of stroke patients who died in hospital within 30 days was 18.7%.

“In its fifth year, the Health Care in Canada series is now instrumental in furthering the public’s knowledge of the health care system, and is routinely used by policy-makers, hospital administrators, researchers, other health care system stakeholders, and students,” says Jennifer Zelmer, Vice-President, Research and Analysis.

HEALTH CARE IN CANADA 2004: A FIFTH ANNUAL REPORT

Health Care in Canada 2004, produced by CIHI with assistance from Statistics Canada, offers current and updated information at local, regional, national, and international levels from many different sources, including CIHI studies and from Statistics Canada data.

The 2004 report also includes new and updated information on 24 key measures of health and health care for 78 health regions in Canada, representing more than 90% of the country’s population. Regions with a population of 75,000 or more are included in the comparisons. These data are available in the accompanying document, Health Indicators 2004.