Evidence map›Paper›PMID 34253671›Full record

ArticleBMJ open2021

Epidemiology of healthcare harm in New Zealand general practice: a retrospective records review study.

Sharon Leitch, Susan Dovey, Wayne Cunningham, Katharine Wallis, Kyle Eggleton, Steven Lillis, Andrew McMenamin, Martyn Williamson, David Reith, Ariyapala Samaranayaka and 1 more

Abstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Treatment Harms in Paediatric Primary Care.International journal of environmental research and public health · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sharon LeitchGeneral Practice and Rural Health, Otago Medical School, University of Otago, Dunedin, New Zealand sharon.leitch@otago.ac.nz.ORCID 0000-0001-9939-8773
Susan DoveyGeneral Practice and Rural Health, Otago Medical School, University of Otago, Dunedin, New Zealand.
Wayne CunninghamDepartment of Family Medice, RCSI Bahrain, Manama, Bahrain.
Katharine WallisPrimary Care Clinical Unit, University of Queensland, Brisbane, Queensland, Australia.
Kyle EggletonGeneral Practice and Primary Healthcare, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.
Steven LillisStudent Health, University of Waikato, Hamilton, New Zealand.
Andrew McMenaminTe Ngae Medical Centre, Rotorua, New Zealand.
Martyn WilliamsonGeneral Practice and Rural Health, Otago Medical School, University of Otago, Dunedin, New Zealand.
David ReithOffice of the Dean, Otago Medical School, University of Otago, Dunedin, New Zealand.
Ariyapala SamaranayakaPreventive and Social Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand.
Murray TilyardGeneral Practice and Rural Health, Otago Medical School, University of Otago, Dunedin, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine the epidemiology of healthcare harm observable in general practice records.

designRetrospective cohort records review study.

setting72 general practice clinics were randomly selected from all 988 New Zealand clinics stratified by rurality and size; 44 clinics consented to participate.

participants9076 patient records were randomly selected from participating clinics.

interventionEight general practitioners examined patient records (2011-2013) to identify harms, harm severity and preventability. Analyses were weighted to account for the stratified sampling design and generalise findings to all New Zealand patients.

main outcome measuresHealthcare harm, severity and preventability.

resultsReviewers identified 2972 harms affecting 1505 patients aged 0-102 years. Most patients (82.0%, weighted) experienced no harm. The estimated incidence of harm was 123 per 1000 patient-years. Most harms (2160; 72.7%, 72.4% weighted) were minor, 661 (22.2%, 22.8% weighted) were moderate, and 135 (4.5%, 4.4% weighted) severe. Eleven patients died, five following a preventable harm. Of the non-fatal harms, 2411 (81.6%, 79.4% weighted) were considered not preventable. Increasing age and number of consultations were associated with increased odds of harm. Compared with patients aged ≤49 years, patients aged 50-69 had an OR of 1.77 (95% CI 1.61 to 1.94), ≥70 years OR 3.23 (95% CI 2.37 to 4.41). Compared with patients with ≤3 consultations, patients with 4-12 consultations had an OR of 7.14 (95% CI 5.21 to 9.79); ≥13 consultations OR 30.06 (95% CI 21.70 to 41.63).

conclusionsStrategic balancing of healthcare risks and benefits may improve patient safety but will not necessarily eliminate harms, which often arise from standard care. Reducing harms considered 'not preventable' remains a laudable challenge.

Indexed as

General PracticeDelivery of Health CareFamily PracticeHumansNew ZealandRetrospective Studieshealth & safetyprimary carequality in health care

Identifiers

PMID34253671
PMCPMC8276280

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.