Patient assessments of a hypothetical medical error: effects of health outcome, disclosure, and staff responsiveness
- 1Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
- 2Department of Community Medicine, University Hospitals of Geneva, Geneva, Switzerland
- 3Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, Switzerland
- Correspondence to: Dr T V Perneger Quality of Care Service, University Hospitals of Geneva, 1211 Geneva 14, Switzerland; thomas.perneger{at}hcuge.ch
- Accepted 24 January 2006
Abstract
Objective: To assess whether patients’ perceptions of a hypothetical medical error are influenced by staff responsiveness, disclosure of error, and health consequences of the error.
Design: Hypothetical scenario describing a medication error submitted by mail. Three factors were manipulated at random: rapid v slow staff responsiveness to error; disclosure v non-disclosure of the error; and occurrence of serious v minor health consequences.
Participants: Patients discharged from hospital.
Measures: Assessment of care described in the scenario as bad or very bad, rating of care as unsafe, and intent to not recommend the hospital.
Results: Of 1274 participants who evaluated the scenario, 71.4% rated health care as bad or very bad, 60.2% rated healthcare conditions as unsafe, and 25.5% stated that they would not recommend the hospital. Rating health care as bad or very bad was associated with slow reaction to error (odds ratio (OR) 2.8, 95% CI 2.1 to 3.6), non-disclosure of error (OR 2.0, 95% CI 1.5 to 2.6), and serious health consequences (OR 3.4, 95% CI 2.6 to 4.5). Similar associations were observed for rating healthcare conditions as unsafe and the intent to not recommend the hospital. Younger patients were more sensitive to non-disclosure than older patients.
Conclusions: Former patients view medical errors less favorably when hospital staff react slowly, when the error is not disclosed to the patient, and when the patient suffers serious health consequences.
Footnotes
-
↵† Deceased.
-
Funded by the Quality of Care Program of University Hospitals of Geneva. There was no external funding.
-
Competing interests: none.
-
Part of this paper was presented at the 25th Annual Meeting of the Society for Medical Decision Making, Chicago, USA, October 2003.
-
AC and AV contributed equally to this article.
-
Ethics review: As a quality improvement project that entailed minimal risk to participants, the Hospital Research Ethics Committee exempted the survey from full formal review.
