[Self-monitoring of physicians for the detection of iatrogenic diseases].
Iatrogenic diseases are defined as illnesses due to diagnostic or therapeutic procedures. The authors explore the possibility of recording iatrogenic diseases by a physician self-monitoring system. The responsible physician himself records his/her patients' iatrogenic complications on hospital discharge, after which the authors examine retrospectively all charts of the patients involved and a random sample of patients not included. The results show that in one year 208 of 1618 patients were recorded as having an iatrogenic disease which was severe in 88. 7.1% of these cases were not confirmed retrospectively (false positives). On the other hand, about one third of iatrogenic illnesses were not recorded (false negatives), though these were less severe cases only. We calculated that 17% of our patients had iatrogenic diseases, 22% of these were predictable. About a third of the patients had iatrogenic disease before hospital admission, and these patients had more severe, and other, iatrogenic diseases than those who acquired them during hospitalization. Iatrogenic complications affect other organ systems than non-iatrogenic acquired diseases. On average, patients with iatrogenic diseases were 6 years older and hospitalized 10 days longer than other patients. Although not all cases may be recorded, we believe that physician self-monitoring is preferable to other systems for recording iatrogenic diseases, since it may have a direct teaching effect on those who cause the illness.
D006801:Humans; D007049:Iatrogenic Disease / Q000175:diagnosis* / Q000517:prevention & control; D007388:Internal Medicine; D008318:Malpractice; D012189:Retrospective Studies; D013557:Switzerland
Arztliche Selbstkontrolle zur Erfassung iatrogener Krankheiten.