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How safe is primary care? A systematic review
Sukhmeet Singh Panesar1, Debra deSilva2, Andrew Carson-Stevens3
1Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
BMJ Quality & Safety
|December 31, 2015
Summary
Patient safety incidents in primary care are common, occurring in 2-3 per 100 consultations. While most incidents do not cause severe harm, diagnostic and prescribing errors pose the greatest risk.
Area of Science:
- Healthcare Quality and Safety
- Primary Care Medicine
- Medical Error Analysis
Background:
- Patient safety in hospitals is well-studied, but less is known about safety in primary care settings.
- Improving patient safety is a key policy and practice objective.
Purpose of the Study:
- To investigate the frequency of patient safety incidents in primary care.
- To determine the association between these incidents and patient harm.
Main Methods:
- A systematic review of published and unpublished studies from 1980 to 2014.
- Inclusion of studies on any type of patient safety incident.
- Critical appraisal and narrative synthesis of data from 9 systematic reviews and 100 primary studies.
Main Results:
- Patient safety incidents occurred at rates from <1 to 24 per 100 consultations.
- Population-based studies indicated a median of 2-3 incidents per 100 consultations.
- Approximately 4% of incidents were associated with severe harm, with diagnostic and prescribing errors being most frequent.
Conclusions:
- Safety incidents are relatively common in primary care.
- Most incidents do not lead to severe patient harm.
- Diagnostic and prescribing errors represent the most significant risks for avoidable harm.
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