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Outpatient care: preventable adverse events too frequent

At least 40% of severe adverse events related to outpatient care that have resulted in hospitalisation appear to be preventable. They are chiefly drug-related.

In France, according to a nationwide study carried out in 2004, between 3% and 5% of inpatients have been hospitalised as a result of adverse events linked to outpatient care.

A regional study was carried out in 2008. Conducted over 2 months, in 7 public and private hospitals selected at random, it involved nearly 3000 inpatients in the Aquitaine region.

Around 2.5% of the patients admitted to hospital were there due to an adverse event associated with outpatient care. 75% of these cases involved therapeutic interventions, 20% diagnostic procedures, and 5% preventive measures. At least 40% of the severe adverse events resulting in hospitalisation were preventable. Of these, drugs were implicated in 80% of cases, chiefly oral anticoagulants, neuroleptics and diuretics. The patients most frequently affected were frail patients (cardiovascular disease, isolation, etc.), and the elderly or those with reduced autonomy. The main causes were the failure to provide written instructions, the lack of treatment monitoring or of re-assessment, difficulties in gaining access to care.

This study confirms the urgency of implementing preventive actions to identify and intercept errors to improve the quality of patient care.

©Prescrire 1 February 2012

"Ambulatory care in France: too many adverse events" Prescrire Int 2012; 21 (124): 40-41. (Pdf, subscribers only).
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