Medical errors related to discontinuity of care from an inpatient to an outpatient setting.
OBJECTIVE
To determine the prevalence of medical errors related to the discontinuity of care from an inpatient to an outpatient setting, and to determine if there is an association between these medical errors and adverse outcomes.


METHODS
Eighty-six patients who had been hospitalized on the medicine service at a large academic medical center and who were subsequently seen by their primary care physicians at the affiliated outpatient practice within 2 months after discharge.


METHODS
Each patient's inpatient and outpatient medical record was reviewed for the presence of 3 types of errors related to the discontinuity of care from the inpatient to the outpatient setting: medication continuity errors, test follow-up errors, and work-up errors.


METHODS
Rehospitalizations within 3 months after the initial postdischarge outpatient primary care visit.


RESULTS
Forty-nine percent of patients experienced at least 1 medical error. Patients with a work-up error were 6.2 times (95%confidence interval [95% CI], 1.3 to 30.3) more likely to be rehospitalized within 3 months after the first outpatient visit. We did not find a statistically significant association between medication continuity errors (odds ratio [OR], 2.5; 95%CI, 0.7 to 8.8) and test follow-up errors (OR, 2.4; 95%CI, 0.3 to 17.1) with rehospitalizations.


CONCLUSIONS
We conclude that the prevalence of medical errors related to the discontinuity of care from the inpatient to the outpatient setting is high and may be associated with an increased risk of rehospitalization.
Moore
Carlton
C
Division of General Internal Medicine, Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA. carlton.moore@mssm.edu
Wisnivesky
Juan
J
Williams
Stephen
S
McGinn
Thomas
T
D000553:Ambulatory Care / Q000592:standards; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000592:standards*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015203:Reproducibility of Results