National Trends in Patient Safety for Four Common Conditions, 2005–2011

作者：Yun Wang, Noel E. Eldridge, Mark L. Metersky, Nancy R. Verzier, Thomas P. Meehan, Michelle M. Pandolfi, JoAnne Micale Foody, Shih‐Yieh Ho, Deron H. Galusha, Rebecca Kliman, Nancy L. Sonnenfeld, Harlan M. Krumholz, James B Battles · 发表于：New England Journal of Medicine · 年份：2014 · DOI：10.1056/nejmsa1300991 · 被引用次数：258 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Patient Safety and Medication Errors、Acute Myocardial Infarction Research

BACKGROUND: Changes in adverse-event rates among Medicare patients with common medical conditions and conditions requiring surgery remain largely unknown. METHODS: We used Medicare Patient Safety Monitoring System data abstracted from medical records on 21 adverse events in patients hospitalized in the United States between 2005 and 2011 for acute myocardial infarction, congestive heart failure, pneumonia, or conditions requiring surgery. We estimated trends in the rate of occurrence of adverse events for which patients were at risk, the proportion of patients with one or more adverse events, and the number of adverse events per 1000 hospitalizations. RESULTS: The study included 61,523 patients hospitalized for acute myocardial infarction (19%), congestive heart failure (25%), pneumonia (30%), and conditions requiring surgery (27%). From 2005 through 2011, among patients with acute myocardial infarction, the rate of occurrence of adverse events declined from 5.0% to 3.7% (difference, 1.3 percentage points; 95% confidence interval [CI], 0.7 to 1.9), the proportion of patients with one or more adverse events declined from 26.0% to 19.4% (difference, 6.6 percentage points; 95% CI, 3.3 to 10.2), and the number of adverse events per 1000 hospitalizations declined from 401.9 to 262.2 (difference, 139.7; 95% CI, 90.6 to 189.0). Among patients with congestive heart failure, the rate of occurrence of adverse events declined from 3.7% to 2.7% (difference, 1.0 percentage points; 95% CI,...