Patient-related factors associated with an increased risk of being a reported case of preventable harm in first-line health care, 2020, Fernholm et al

[Andy]

Background
Patient safety issues in primary health care and in emergency departments have not been as thoroughly explored as patient safety issues in the hospital setting. Knowledge is particularly sparse regarding which patients have a higher risk of harm in these settings. The objective was to evaluate which patient-related factors were associated with risk of harm in patients with reports of safety incidents.

Methods
A case–control study performed in primary health care and emergency departments in Sweden. In total, 4536 patients (cases) and 44,949 controls were included in this study. Cases included patients with reported preventable harm in primary health care and emergency departments from January 1st, 2011 until December 31st, 2016.

Results
Psychiatric disease, including all psychiatric diagnoses regardless of severity, nearly doubled the risk of being a reported case of preventable harm (odds ratio, 1.96; p < 0.001). Adjusted for income and education there was still an increased risk (odds ratio, 1.69; p < 0.001). The preventable harm in this group was to 46% diagnostic errors of somatic disease.

Conclusion
Patients with psychiatric illness are at higher risk of preventable harm in primary care and the emergency department. Therefore, this group needs extra attention to prevent harm.

Open access, https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-020-1087-4

 

[Wonko]

erm...possibly the people treating them require extra attention instead.

(it seems much more likely, to me, that the harm to patients is caused directly or indirectly by staffs lack of understanding/care/concern towards those who are not 'typical' patients, rather than as a direct result of patients actions - so watching the patients may not, in fact, be the correct response.)

 

[Saz94]

The preventable harm in this group was to 46% diagnostic errors of somatic disease.

What does that mean? Errors of diagnosing physical disease as psychological? Or errors of (supposedly) diagnosing psychological disease as physical?

 

[Hoopoe]

It means they had a nonpsychiatric illness that was erroneously considered to be psychiatric.

 

[Saz94]

And 46%, does that mean that 46% of the preventable harm was due to these diagnostic errors? Or that 46% of people were misdiagnosed?