March 15, 2012
Study Finds Developing Countries Suffer From Poor Hospital Care
A new study finds that patient safety is lacking in the world´s developing countries.
According to a recent BBC News report, the study, published in the British Medical Journal, looked at the hospital records of over 15,000 patients in 26 hospitals in 8 countries, Egypt, Jordan, Kenya, Morocco, South Africa, Tunisia, Sudan and Yemen.
The study found that 8.2 percent of patients suffered an adverse event, one where an unintended injury resulted in permanent disability or death that came about as a result of healthcare management.
The most common adverse event, at 34.2 percent, is therapeutic error. Therapeutic error is where the diagnosis is made but the proper therapeutic response was not ordered or not delivered. The next most common error, which followed at less than twenty percent was diagnostic error where the diagnosis was not made properly or in a timely manner or there was a failure to make the proper diagnosis from the information given.
Some hospitals reported almost one in five patients were affected by accidents or poor treatments. The researchers note that adverse events happen in developed nations also, but the results are not as tragic. Patients are more likely to survive an adverse event in a developed nation but will more likely die from the same event in a developing nation.
According to Dr. Itziar Larizgoitia, the coordinator of the World Health Organization (WHO) patient safety group, doctors and nurses are not to blame for the poor hospital care. He says, “It is not the intent of health professionals to fail on patients. Rather, the harm caused by health care is often the result of failing process and weak systems. Often doctors and nurses in developing countries have not received adequate training, are not adequately supervised, do not have protocols to follow nor the means to record patients´ information, or in some cases, do not even have running water with which to wash their hands.”
The study also found that age and length of stay has an effect on the survivability of an adverse event. Older patients have a higher chance of dying due to an adverse event than younger patients. But the longer the stay the larger the risk of failing to survive.
Dr. Ross Wilson, chief medical officer of the New York City health and hospital corporation and author of the paper, told BBC News: “The older you are the more at risk you are and if you have that event the more at risk you are of significant consequences like permanent disability or death. In addition the longer you are in hospital the more at risk you are, but these are the same as in the developed world. People at the extremes of life are more at risk.”
In order to solve this issue the researchers agree that the problem is greater than just adding more resources. Dr. Larizgoitia says culture change is also required.
He told BBC News reporter Matt McGrath: “Developing and adapting patient safety practices to the different cultural contexts are essential. Safety practices that work in one context may not work in another one. It is essential to understand which practices can work effectively in different contexts and it is also essential to facilitate and encourage the adoption of the culturally and context specific practices.”