title: Preventable in-hospital medical injury under the "no fault" system in New Zealand.
abstract: OBJECTIVE
  To describe the pattern of preventable in-hospital medical injury under the "no fault" system and to assess the level of serious preventable patient harm.
  
  
  METHODS
  Cross sectional survey using a two stage retrospective assessment of medical records conducted by structured implicit review.
  
  
  METHODS
  General hospitals with over 100 beds providing acute care in New Zealand.
  
  
  METHODS
  A sample of 6579 patients admitted in 1998 to 13 hospitals selected by stratified systematic list sample.
  
  
  METHODS
  Occurrence, preventability, and impact of adverse events.
  
  
  RESULTS
  Over 5% of admissions were associated with a preventable in-hospital event, of which nearly half had an element of systems failure. The elderly, ethnic minority groups, and particular clinical areas were at higher risk. The chances of a patient experiencing a serious preventable adverse event subsequent to hospital admission were just under 1%, a figure close to published results from comparable studies under tort. On average, these events required an additional 4 weeks in hospital. System related issues of protocol use and development, communication, and organisation, as well as requirements for consultation and education, were pre-eminent.
  
  
  CONCLUSIONS
  The risk of serious preventable in-hospital medical injury for patients in New Zealand, a well established "no fault" jurisdiction, is within the range reported in comparable investigations under tort.
authors.affiliation: Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand. peter.davis@chmeds.ac.nz
authors.forename: P
authors.initials: P
authors.lastname: Davis
authors.forename: R
authors.initials: R
authors.lastname: Lay-Yee
authors.forename: R
authors.initials: R
authors.lastname: Briant
authors.forename: A
authors.initials: A
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D035881:Compensation and Redress; D005260:Female; D006302:Health Services Research; D006779:Hospitals, Public / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007351:Insurance, Liability; D008297:Male; D008318:Malpractice / Q000191:economics* / Q000706:statistics & numerical data; D008485:Medical Audit; D019300:Medical Errors / Q000145:classification / Q000517:prevention & control / Q000706:statistics & numerical data*; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D017751:Safety Management