title: Patients' reports of adverse events: a data linkage study of Australian adults aged 45 years and over.
abstract: BACKGROUND
  Understanding a patient's hospital experience is fundamental to improving health services and policy, yet, little is known about their experiences of adverse events (AEs). This study redresses this deficit by investigating the experiences of patients in New South Wales hospitals who suffered an AE.
  
  
  METHODS
  Data linkage was used to identify a random sample of 20 000 participants in the 45 and Up Cohort Study, out of 267 153 adults aged 45 years and over, who had been hospitalised in the prior 6 months. A cross-sectional survey was administered to these patients to capture their experiences, including whether they had an AE and received honest communication about it.
  
  
  RESULTS
  Of the 18 993 eligible participants, 7661 completed surveys were received (40% response rate) and 474 (7%) reported having an AE. Most AEs related to clinical processes and procedures (33%), or medications and intravenous fluids (21%). Country of birth and admission through emergency were significant predictors of the occurrence of an event. An earlier admission in the prior 6 months or a transfer to another healthcare facility was also associated with more AEs. Of those who suffered an AE, 58% reported serious or moderate effects.
  
  
  CONCLUSIONS
  Given the exclusions in our sample population (under 45 years), the AE rate reported by patients of 7% is similar to the approximately 10% rate reported in the general population by retrospective medical record reviews. AE data that include patient experience may provide contextual information currently missing. Capturing and using patient experience data more effectively is critical; there may be opportunities for applying co-design methodology to improve the management of AEs and be more responsive to patients' concerns.
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Merrilyn Margaret
authors.initials: MM
authors.lastname: Walton
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Reema
authors.initials: R
authors.lastname: Harrison
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kelly
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Smith-Merry
authors.affiliation: School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Manias
authors.affiliation: Sydney University, Sydney Medical School, Sydney, New South Wales, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Jorm
authors.affiliation: Monash University, Clayton, Victoria, Australia.
authors.forename: Rick
authors.initials: R
authors.lastname: Iedema
mesh_terms: D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000145:classification / Q000706:statistics & numerical data*; D008875:Middle Aged; D009517:New South Wales; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Adverse events, epidemiology and detection; Patient safety; Patient satisfaction; Patient-centred care