title: Perceptions of quality and safety and experience of adverse events in 27 European Union healthcare systems, 2009-2013.
abstract: OBJECTIVE
  To assess trends in the perception of quality and safety between 2009 and 2013 in the European Union (EU).
  
  
  METHODS
  We analysed data from waves 72.2 and 80.2 of the Eurobarometer survey. Multilevel logistic regression models adjusted for sociodemographic factors and country-level health expenditure were fitted to assess changes between 2009 and 2013 in each of the assessed outcomes.
  
  
  METHODS
  Twenty-seven EU member states.
  
  
  METHODS
  A total of n = 26 663 (2009) and n = 26 917 (2013) individuals aged ≥15 years.
  
  
  METHODS
  Outcomes included the perception of being harmed in hospital and non-hospital care; rating of the overall quality of the healthcare system; and personal or family experience of adverse events.
  
  
  RESULTS
  Respondents in 2013 were more likely to think that it was likely to be harmed in hospital (Odds Ratio [OR] = 1.09; 95% Confidence Interval [CI]: 1.05-1.13; P < 0.001) and non-hospital care (OR = 1.11; 95% CI: 1.07-1.15; P < 0.001), compared to 2009. However, they were more likely to rate the quality of their country's healthcare system as good (OR = 1.26; 95% CI: 1.21-1.32; P < 0.001) and no significant change over time was identified in reported experience of adverse events (OR = 1.00; 95% CI: 0.95-1.05; P = 0.929). Lower health expenditure and decrease in health expenditure between the two waves were associated with worse outcomes in overall quality and perceptions of harm. There was significant variation between and within countries in all indicators.
  
  
  CONCLUSIONS
  The public's perception of safety in European healthcare systems declined in recent years, which highlights that there are safety issues that could be addressed.
authors: Department of Primary Care and Public Health, School of Public Health, Imperial College London, 310 The Reynolds Building, St. Dunstan's Road, London W6 8RP, UK.
authors: Filippos T
authors: FT
authors: Filippidis
authors: Department of Primary Care and Public Health, School of Public Health, Imperial College London, 310 The Reynolds Building, St. Dunstan's Road, London W6 8RP, UK.
authors: Saba S
authors: SS
authors: Mian
authors: Department of Primary Care and Public Health, School of Public Health, Imperial College London, 310 The Reynolds Building, St. Dunstan's Road, London W6 8RP, UK.
authors: Christopher
authors: C
authors: Millett
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D005062:European Union; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D061214:Patient Safety / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data* / Q000639:trends; D011795:Surveys and Questionnaires
keywords: adverse events; health policy; patient safety; public health