Risk of adverse events from medication errors in general and tertiary hospitals: A cross-sectional design

A thorough investigation of various medical errors to better understand their underlying causes is the first step toward preventing medication errors and improving patient safety. The causes, types, and rates of medication errors can evolve within the healthcare delivery system. In Korea, systematic data on patient safety incidents remains limited, although healthcare institutions are progressively developing comprehensive information sharing systems.

This study aimed to analyze factors influencing the risk of adverse events from medication errors in general and tertiary hospitals in Korea using national patient safety statistics (2018-2022).

A secondary analysis of 8,606 medication error reports was performed to identify risk factors related to hospital and patient characteristics. Firth penalized logistic regression was employed, and sensitivity analyses excluding pandemic years (2020-2021) were conducted.

The risk of adverse events from medication errors was 1.5 times higher in general hospitals with ≥500 beds than in those with <500 beds. Emergency rooms and intensive care units demonstrated the highest risks across both hospital types. Day shifts showed protective effects compared to night shifts in both hospital types. Temporal analysis revealed significantly higher risks in earlier years (2018-2020) compared to 2022, suggesting improvements in medication safety systems. Sensitivity analyses confirmed that pandemic years amplified risks in high-acuity areas, and the protective effect of day shifts was particularly critical during this period. In general hospitals, adult age groups (≥20 years) showed elevated risks, with pediatrics demonstrating 1.7 times higher risk than general surgery.

These findings highlight the need for tailored interventions based on hospital type, location, temporal factors, and patient characteristics. Developing department-specific safety strategies for high-acuity care environments, optimizing staffing patterns particularly during night shifts, implementing age-specific medication management protocols, and continuously improving safety systems are essential to prevent medication errors, enhance patient safety, and improve healthcare outcomes.