Patient and hospital characteristics that influence incidence of adverse events in acute public hospitals in Portugal: a retrospective cohort study

Sousa, Paulo; Uva, António de Sousa; Serranheira, Florentino; Nunes, Carla

doi:10.1093/intqhc/mzx190

Cited by 56 publications

(58 citation statements)

References 29 publications

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“…Nevertheless, this situation must be carefully analyzed because these results may reflect a real increase in the in-hospital ADE frequency, but they may also be associated with greater awareness of hospitals about the patients' safety and, subsequently, better practice regarding the recording and encoding of these events. In a study carried out at nine Portuguese acute care hospital centers 9 , it was observed that the adverse event frequency was higher in the accredited hospitals (13.7% vs. 11.2%). A reasonable explanation for these results, according to the authors, may be associated with the fact that the accredited hospitals display a greater awareness of the patient's safety and have a systemic practice of data recording and analysis.…”

Section: Discussionmentioning

confidence: 98%

“…In Portugal, the evidence available also points to a high rate of in-hospital ADEs. A study carried out in nine acute care public hospital centers, using the clinical record review methodology, identified an incidence of 12.5% adverse events in the year 2013, of which 9.8% were associated with drug errors, representing the third most frequent adverse event 9 . According to other studies carried out in Portuguese public hospitals, using administrative data, 1.46% and 1.88% of hospitalized patients showed at least one ADE 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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In-hospital adverse drug events: analysis of trend in Portuguese public hospitals

2020

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The objectives of this study were to analyze in-hospital adverse drug events (ADEs) in Portuguese public hospitals, and their association with mortality and the duration of hospitalization. We analyzed an administrative database containing the registration of all hospitalizations occurring in Portuguese public hospitals in 2013-2015. ADEs were identified using the codes E850-858.9 and E930-949.9 from ICD-9-CM. We identified all episodes with registration of in-hospital ADE and we compared them with a random sample of an equal number of episodes with no events recorded. A total of 3,041,443 cases were analyzed, 60,521 presented at least one ADE from which 17,213 occurred in hospital context. The most frequent drug classes associated with ADE were the antineoplastics/immunosuppressant drugs, antibiotics and steroids. Patient characteristics associated with a greater occurrence of in-hospital ADEs (all with p < 0.001) were medical admissions (OR = 1.29), the diagnosis - myeloid leukaemia (OR = 18.63), nephrotic syndrome (OR = 15.75), pneumonia (OR = 1.33) -, a higher number of secondary diagnoses (OR = 1.27), and increased duration of hospital stay (OR = 1.06). Hospitalizations with records of in-hospital ADEs presented a significantly higher mortality (9.6% vs. 4.5) and duration of hospitalization (22.6 vs. 6.4 days). ADEs were shown to be directly associated with an increase in the duration of hospital stay of 8.18 days. This study adds some interesting insights related to the most frequent drug classes and patient characteristics that can influence the frequency of ADEs in Portuguese public hospitals and also the burden of injury resulting from them.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

In-hospital adverse drug events: analysis of trend in Portuguese public hospitals

2020

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“…Bilingual hospitals also had a higher rate of harm overall than English-speaking hospitals. This could be due to the fact that a greater proportion of bilingual hospitals are academic institutions, which generally have a higher rate of harm [49,50]. While this could provide an explanation for the…”

Section: Discussionmentioning

confidence: 99%

The impact of hospital language on the rate of in-hospital harm. A retrospective cohort study of home care recipients in Ontario, Canada

Reaume

Batista

Talarico³

et al. 2020

BMC Health Serv Res

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Background: Patients who live in minority language situations are generally more likely to experience poor health outcomes, including harmful events. The delivery of healthcare services in a language-concordant environment has been shown to mitigate the risk of poor health outcomes related to chronic disease management in primary care. However, data assessing the impact of language-concordance on the risk of in-hospital harm are lacking. We conducted a population-based study to determine whether admission to a language-discordant hospital is a risk factor for in-hospital harm.Methods: We used linked administrative health records to establish a retrospective cohort of home care recipients (from 2007 to 2015) who were admitted to a hospital in Eastern or North-Eastern Ontario, Canada. Patient language (obtained from home care assessments) was coded as English (Anglophone group), French (Francophone group), or other (Allophone group); hospital language (English or bilingual) was obtained using language designation status according to the French Language Services Act. We identified in-hospital harmful events using the Hospital Harm Indicator developed by the Canadian Institute for Health Information.Results: The proportion of hospitalizations with at least 1 harmful event was greater for Allophones (7.63%) than for Anglophones (6.29%, p < 0.001) and Francophones (6.15%, p < 0.001). Overall, Allophones admitted to hospitals required by law to provide services in both French and English (bilingual hospitals) had the highest rate of harm (9.16%), while Francophones admitted to these same hospitals had the lowest rate of harm (5.93%). In the unadjusted analysis, Francophones were less likely to experience harm in bilingual hospitals than in hospitals that were not required by law to provide services in French (English-speaking hospitals) (RR = 0.88, p = 0.048); the opposite was true for Anglophones and Allophones, who were more likely to experience harm in bilingual hospitals (RR = 1.17, p < 0.001 and RR = 1.41, p < 0.001, respectively). The risk of harm was not significant in the adjusted analysis.(Continued on next page)

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“…Zbog svega toga preporuča se ostaviti hospitalizaciju samo za slučajeve kada ambulantno liječenje ne daje rezultate, jer svaki dolazak bolesnika s demencijom u bolnicu otvara mogućnosti neželjenih događaja (2,4,(13)(14)(15)(16).…”

Section: Discussionunclassified

“…Due to all these reasons, it is recommended to consider hospitalization only in cases where outpatient treatment does not produce results, as each hospital admission of patients with dementia increases the risk of adverse events (2,4,(13)(14)(15)(16).…”

Section: Zaključakmentioning

confidence: 99%

The Frequency and Causes of Physical Complications/ Adverse Events During the Hospitalization of Patients with Dementia

et al. 2019

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Uvod: Osobe s demencijom osjetljivije su na razvoj različitih komplikacija/neželjenih događaja u odnosu na osobe iste dobne skupine bez demencije. Češće se zaprimaju u bolnicu, gdje imaju veću prevalenciju komplikacija i povećanu smrtnost. Cilj: ispitati učestalost hitnih premještaja bolesnika s demencijom zbog tjelesnih komplikacija iz Klinike za psihijatriju Vrapče na somatske odjele drugih bolnica. Metode: U ovom retrospektivnom istraživanju analizirali smo podatke bolesnika s demencijom koji su liječeni od 1. siječnja do 31. kolovoza 2019. godine na Odjelu psihogerijatrije u Klinici za psihijatriju Vrapče s naglaskom na vrijeme trajanja hospitalizacije i razloge otpusta koji su doveli do premještaja s Odjela. Rezultati: Od siječnja do kraja kolovoza 2019. godine na Odjel psihogerijatrije u Klinici zaprimljeno je ukupno 256 bolesnika (67,97 % žena i 32,03 % muškaraca). Prosječna dob žena bila je 80,5, a muškaraca 76,4 godina. Premješteno na somatski odjel (bolnicu) bilo je 28 % bolesnika (40,24 % muškaraca, 23 % žena), a od toga 39 % u prvih sedam dana od dolaska u bolnicu. Pneumonija je bila vodeća somatska dijagnoza kod 19 % premještenih. Prosječno trajanje hospitalizacije među svim ispitanicima bilo je kod muškaraca 33,08 dana, a kod

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Patient and hospital characteristics that influence incidence of adverse events in acute public hospitals in Portugal: a retrospective cohort study

Cited by 56 publications

References 29 publications

In-hospital adverse drug events: analysis of trend in Portuguese public hospitals

In-hospital adverse drug events: analysis of trend in Portuguese public hospitals

The impact of hospital language on the rate of in-hospital harm. A retrospective cohort study of home care recipients in Ontario, Canada

The Frequency and Causes of Physical Complications/ Adverse Events During the Hospitalization of Patients with Dementia

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