入院患者における有害事象発生率の動向 (2010年−2019年)
Noel Eldridge1,2, Yun Wang3,4,5, Mark Metersky6
1Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland.
JAMA
|July 12, 2022
まとめ
2010年から2019年にかけて,米国の病院で患者の安全性が向上し,主要な疾患およびすべての他の疾患の有害事象が著しく減少しました. これらの患者安全性傾向を確認するには,さらなる研究が必要である.
科学分野:
- 医療の質と安全
- 医療情報工学
- 公衆衛生
背景:
- 患者の安全は米国で重要な国家優先事項です
- その重要性にもかかわらず,過去10年間の患者の安全性に関する包括的な評価は欠けています.
- 医療の質を評価するには 有害事象の傾向を理解することが重要です
研究 の 目的:
- 米国における入院患者の有害事象発生率の変化を決定する.
- 患者安全に関する10年間の進展 (2010年から2019年) を評価する.
主な方法:
- メディケアの患者安全監視システム (2010年−2019年) のデータを活用した連続的な横断的な研究.
- 4つの状態グループと"他のすべての状態"に焦点を当てた,米国の急性ケア病院の244,542人の成人を含む.
- 副作用は4つの領域に分類された: 薬物によるイベント,病院で得られた感染症,処置後のイベント,および一般的な有害事象.
主要な成果:
- 急性心筋梗塞,心不全,肺炎,重大外科手術において,有害事象の発生率の有意な低下が観察されました.
- "他のすべての条件"では,調整された有害事象の割合も2012年から2019年の間に大幅に減少しました.
- 薬剤による有害事象,病院内感染,および一般的な有害事象のリスク調整率は,すべての研究対象患者群で著しく減少した.
結論:
- この研究は,2010年から2019年の間に米国の病院における主要な疾患およびその他の疾患に対する有害事象の有意な減少を示しています.
- これらの発見は,患者の安全性に関する肯定的な傾向を示唆しますが,これらの変化の範囲を完全に理解するためにさらなる研究が推奨されます.
- 特定の有害事象の減少は,病院での治療の質の改善を強調しています.
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