The significant incidence of events in hospitals and the costs related to them has been well documented. Workplace stress, rising insurance premiums and a practice model that provides inadequate support to caregivers is causing many professionals to leave the practice of obstetrics. This trend is limiting access to maternity care services.
In the United States, between 44,000 and 98,000 patients die every year in hospitals as a result of errors by health care providers. Clinical error is the fourth leading cause of death in the United States, resulting in more deaths than traffic accidents, breast cancer and HIV infection. The total national costs of preventable adverse events are estimated to be $17 to $20 billion annually.1 A report from Healthgrades Inc. from 2004 suggested deaths due to medical error had been under-reported in the Institute of Medicine (IOM) report. Their new data estimated that approximately 195,000 deaths per year are due to preventable hospital errors.2
In England, the National Health Service (2000) reports that adverse events causing harm to patients occurred in 10% of hospital admissions. The cost to the National Health Service was estimated at 2 billion pounds per year, excluding the human and wider economic costs.3 In 2004 the NHS reported medical errors were responsible for 40,000 preventable deaths annually.4
In Canada the published Baker and Norton report revealed that 7.5% of people entering an acute care facility experienced ≥ 1 adverse events resulting in 9000 to 24000 deaths. This report also stated 70,000 of the adverse events were preventable and 37% of these highly preventable.5 In a review by the Canadian Institute for Health Information of patients admitted to Ontario Hospitals from 1992 to 1997 demonstrated 3.5 to 5 per cent experienced adverse events.6,7 As staggering as these figures are, evidence from the literature would suggest that 95% of clinical error goes unreported.8 A recent report indicates 18% of physicians and 24% of the public are aware of errors occurring in hospitals that had serious consequences (death, long term disability and severe pain).9
1. Kohn et al. To err is Human, Building a Safer Health System. Institute of Medicine 2000 National Academy Press. Washington, DC 20418
2. HealthGrades in the news. Golden (CO): Health Grades, Inc.; 2004. Available: http://www.healthgrades.com/media/DMS/pdf/HealthGradesInTheNews.pdf (accessed 2006 Oct).
3. A Report of an Expert Group on Learning From Adverse Events in the NHS; Department of Health on Behalf of the Controller of Her Majesty’s Stationary Office. J 00000000 05/00 C40 (077240) 2000.
4. Carvel J. Healthcare Errors Kill 40,000 a year says Charity, 2004. Available: http://www.guardian.co. September 29,2004
5. Baker PR, Norton PG et al. The Canadian adverse events study, CMAJ 2004 May : 170(11), 1678-86
6. Hunter, D., Bains, N. “Rates of adverse events among hospital admissions and day surgeries in Ontario from 1992 to 1997.” Canadian Medical Association Journal. 1999, 160(11): 1585-6.
7. Wanzel, K.R., Jamieson, C.G., et al. « Complications on a general surgery service: incidence and reporting. [comment].” Canadian Journal of Surgery. 43 (2): 113-7, 2000.
8. Hallam, K. Hearings look at fixes for medical errors. Modern Healthcare, 2000, 30(5), 8-9.
9.Blendon et al. Views of the practicing physicians and the public on medical errors. The New England Journal of Medicine 2002,347(24):1933-1940
