Low rate of adverse events recorded in English primary care

A study by Dr Carmen Tsang and colleagues at Imperial College London has found a low incidence of patient safety incidents recorded in general practice. The research, which was published by the British Journal of General Practice, measured the extent of patient safety incidents recorded in 74 763 patients at 457 English general practices between 1999 and 2008, and the patient characteristics associated with these adverse events.

Older patients, those with more comorbid diseases or who had more previous emergency admissions to hospital were at greater risk of complications of care. Dr Carmen Tsang, lead author of the paper, says “Our finding of a low incidence of patient harm in general practice supports previously published studies. To better understand these adverse events, we must also examine the healthcare interactions from which they originate, and consider how to reduce the incidents that are potentially preventable”.

Outcomes following adverse events, including emergency admissions and death, are important because they may be preventable. The low rate of recording of adverse events in primary care may reflect under-recording of safety incidents occurring in this setting. Routine recording of adverse events, may be less frequent and less precise than recording of chronic diseases. The reasons for the low rate of adverse events detected needs to be better understood, particularly if this rate is an under-estimation of the true extent of iatrogenic patient harm in primary care.