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June 16, 2024
Global Increase in Patient Harms: A Growing Concern
A significant rise in patient harms globally has been observed over the past three decades, with the number of incidents increasing from 11 million in 1990 to 18 million in 2019, according to a recent study published in BMJ Quality & Safety. This 59% increase in patient harms outpaces the 45% growth in the world’s population during the same period, highlighting a critical issue in global healthcare systems.
Older Adults Bear the Brunt
The study reveals that older adults, particularly those aged 65-69, have experienced the steepest rise in patient harms. This demographic is increasingly susceptible to complications from medical procedures and treatments, contributing significantly to the overall increase in incidents.
Preventable Harms: A Global Challenge
In developed nations, over half of inpatient harms are deemed preventable, with this figure rising to 83% in developing countries. These incidents not only undermine health and quality of life but also erode public trust and squander valuable healthcare resources.
Methodology and Data Analysis
To address the issue comprehensively, researchers utilized data from the Global Burden of Disease (GBD) study, encompassing information from 204 countries between 1990 and 2019. This data includes inputs from surveillance systems, government records, health facility reports, and surveys.
Rising Incidence Rates
The overall incidence rate of patient harms in 2019 was 232.5 per 100,000 of the global population, a 10% increase since 1990. The age-standardized incidence rate also rose by 4.5%, highlighting a growing trend across different demographics.
Regional Variations
Significant regional variations were observed, with high Sociodemographic Index (SDI) regions experiencing a 60% increase in overall incidence rates. Notably, France showed a decline in cases among 50-70 year olds, possibly due to robust patient safety policies.
Conversely, low SDI regions saw a 14% decrease in overall incidence rates, with a 10% decline in age-standardized rates. However, these regions still face challenges in monitoring and preventing patient harms effectively.
Impact on Age Groups
While the incidence remained largely unchanged for age groups up to 45-49 years, it increased significantly among older adults, particularly those aged 50-94, with the highest rise observed in the 65-69 age bracket. Interestingly, cases among children under 24 years declined, yet those aged 0-4 still accounted for over 17.5% of all cases in 2019.
Explaining the Disparities
The study suggests several reasons for the varying trends between high and low SDI regions. In wealthier countries, higher incidence rates may reflect better monitoring systems and greater healthcare access rather than solely poor quality or overtreatment. Additionally, older populations in these regions may face more complex health challenges, contributing to higher rates of patient harm.
Older Adults and Medication Management
The researchers point out that age-related factors, such as changes in drug metabolism and increased prevalence of chronic conditions, make medication management more challenging for older adults. These complexities can lead to higher rates of adverse effects from medical treatments in this age group.
Conclusion and Implications
The study underscores the urgent need for a systematic, global approach to accurately quantify and address patient harms. As populations age and healthcare services expand, ensuring the safety and quality of medical treatments becomes increasingly imperative.
“As population age and medical services expand with socio-economic development, addressing [adverse effects of medical treatment] incidents becomes a universal imperative to safeguard patient wellbeing and ensure equitable access to quality healthcare,” the researchers conclude.
Looking Forward
This study highlights the critical need for improved monitoring, prevention, and management of patient harms, particularly among older adults. Policymakers and healthcare providers must prioritize patient safety to mitigate these rising trends and enhance the overall quality of care globally.
