Dateline: Friday, June 11, 2004
June 9, 2004, Canadian Institute for Health Information (CIHI)
A new report released today by the Canadian Institute for Health Information
(CIHI) shows that nearly a quarter of Canadian adults (5.2 million people)
report that they, or a member of their family, have experienced a
preventable adverse event. The report Health Care in Canada 2004 is CIHI's
fifth annual publication on the state of the health care system.
The recent publication of the Canadian Adverse Events Study showed us that
more than one million additional hospital days could be attributed to
adverse events. Clearly, we pay a high price on both a human level and as a
health system, says CIHI's Board Chair Graham W. S. Scott, Q.C. New
technology, innovation and a more open reporting system for adverse events
will help ensure that Canadians can continue to have confidence in their
health system.
CIHI's report also compares, for the first time, how often Canadians
experience several different types of adverse events, including being given
the wrong medication or the wrong dose, contracting a hospital-acquired
infection, experiencing birth trauma, or having a foreign object (such as a
sponge) left in them after a procedure.
Some types of events, such as HIV-infected blood transfusions, are very rare
(research estimates the risk at about one per 10 million units of blood).
Others are more common: one in nine adults with health problems reported
receiving wrong medication or the wrong dose by a doctor, hospital, or
pharmacist in the past two years; one in nine adults or one in 11 children
contracted an infection (such as pneumonia or a urinary tract infection)
while in hospital.
This year, CIHI reports on its first national patient safety indicators.
These indicators include:
Foreign objects (e.g., a sponge or instrument) left in after a procedure
Between 2000/2001 and 2002/2003, an estimated one in every 6,667
surgical/medical patients had a foreign object accidentally left in them
following a procedure.
Post-operative hip fracture
Birth trauma
Birth trauma (injury) occurs in about 11.6 of every 1,000 hospital births,
or one birth trauma per 81 newborns.
Experts say that under-reporting makes reducing the incidence of adverse
events more challenging.
Key highlights from CIHIs Health Care in Canada 2004s patient safety
chapters include:
In Canada, researchers Ross Baker and Peter Norton recently found that, in
2000/2001, adverse events occurred in 7.5% of medical/surgical admissions in
non-specialized acute care hospitals. Expert reviewers considered 37% of
those adverse events to be highly preventable.
Experts say that under-reporting makes reducing the incidence of adverse
events more challenging. In a 2003 survey, more than 70% of Canadian health
professionals said that under-reporting of adverse drug reactions was a very
or somewhat serious problem.
About two-thirds of Canadians (67%) think that more litigation could result
in physician shortages in some high-risk specialties, although an even
greater number (76%) believe that the threat of litigation may help ensure
quality care. According to the Canadian Medical Protective Association,
malpractice claims in Canada have stabilized in recent years, and now range
from 1.7 to 2.5 claims per 100 physicians annually.
The report also highlights examples of safe care strategies that have proven
successful, such as using electronic tools to prevent medication errors and
implementing procedures to reduce chance of wrong-side surgeries.
Other Findings, Health Care 2004: As in previous years, CIHIs health report
also presents new information on other topics related to the delivery of
health care in Canada: health human resources, health expenditures, wait
times, and regional trend information on caesarean sections, mortality rates
after a heart attack, and readmission rates for asthma and pneumonia. Some
of the key highlights include:
Fewer people are staying overnight in hospitals (down from 3.6 million in
1985/1986 to 2.9 million in 2000/2001) but day surgery is much more common,
accounting for more than half (50.6%) of inpatient and day surgery
hospitalizations in 2001/2002.
Low-income Canadians were more likely than other Canadians to have stayed
overnight in a hospital in the past year, about as likely to have visited a
doctor, and less likely to have consulted a dentist.
In 2002/2003, 71 facilities in six provinces tracked wait times for
rehabilitation services. Overall, four in 10 patients (42%) were admitted on
the day they were referred. About half (52%) of those referred by inpatient
and rehabilitation units of the same facility waited one day for care.
Median wait times ranged from two to 12 days for other patients who were
referred by residential care facilities, private practices, other
rehabilitation facilities, ambulatory care services and other sources.
The average age of the health workforce is increasing. Between the 1991 and
2001 censuses, the proportion of the working population aged 45 to 64
increased. This trend is more pronounced for people in health occupations
than for those in the workforce as a whole.
In 2003, Canada spent a forecast $121.4 billion on health care, or an
average of $3,839 per person.
Overall heart attack and stroke outcomes among the leading cause of death in
Canada are improving slightly, but substantial differences continue to exist
across the country. Between 1999/2000 and 2001/2002, 11.8% of patients
hospitalized for an acute myocardial infarction (AMI) died in hospital
within 30 days, while the proportion of stroke patients who died in hospital
within 30 days was 18.7%.
Related addresses:
URL 1: secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_09jun2004_e
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