Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults

Abstract

Objective: To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries.

Design: The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries.

Intervention: None.

Setting and participants: A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA who self-reported being chronically ill.

Main outcome measure: A bivariate analysis was performed to determine significant explanatory variables of medical, medication and laboratory error (P < 0.01) for inclusion in a binary logistic regression model.

Results: The final regression model included eight risk factors for self-reported error: age 65 and under, education level of some college or less, presence of two or more chronic conditions, high prescription drug use (four+ drugs), four or more doctors seen within 2 years, a care coordination problem, poor doctor-patient communication and use of an emergency department.

Conclusion: Risk factors with the greatest ability to predict experiencing an error encompassed issues with coordination of care and provider knowledge of a patient's medical history. The identification of these risk factors could help policymakers and organizations to proactively reduce the likelihood of error through greater examination of system- and organization-level practices.