title: Design of a retrospective patient record study on the occurrence of adverse events among patients in Dutch hospitals.
abstract: BACKGROUND
  Various international studies have shown that a substantial number of patients suffer from injuries or even die as a result of care delivered in hospitals. The occurrence of injuries among patients caused by health care management in Dutch hospitals has never been studied systematically. Therefore, an epidemiological study was initiated to determine the incidence, type and impact of adverse events among discharged and deceased patients in Dutch hospitals.
  
  
  METHODS
  Three stage retrospective patient record review study in 21 hospitals of 8400 patient records of discharged or deceased patients in 2004. The records were reviewed by trained nurses and physicians between August 2005 and October 2006. In addition to the determination of presence, the degree of preventability, and causes of adverse events, also location, timing, classification, and most responsible specialty of the adverse events were measured. Moreover, patient and admission characteristics and the quality of the patient records were recorded.
  
  
  CONCLUSIONS
  In this paper we report on the design of the retrospective patient record study on the occurrence of adverse events in Dutch hospitals. Attention is paid to the strengths and limitations of the study design. Furthermore, alterations made in the original research protocol in comparison with former international studies are described in detail.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands. m.zegers@nivel.nl
authors.forename: Marieke
authors.initials: M
authors.lastname: Zegers
authors.forename: Martine C
authors.initials: MC
authors.lastname: de Bruijne
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
authors.forename: Roelof
authors.initials: R
authors.lastname: Waaijman
authors.forename: Gerrit
authors.initials: G
authors.lastname: van der Wal
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D019300:Medical Errors / Q000145:classification / Q000517:prevention & control / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies