Assessing the preventability of emergency hospital admissions. A method for evaluating the quality of medical care in a primary care facility

Academic Article

Abstract

  • The quality of primary medical care was assessed by studying the events leading to 686 emergency admissions of patients from our hospital-based primary care practice. Independent physician reviewers determined that 59 (9 percent) of the admissions were potentially preventable; 40 were due to iatrogenic factors including inadequate follow-up and adverse drug reactions, 12 were due to lack of patient compliance, and seven were due to both iatrogenesis and noncompliance. Adverse drug reactions were the most common cause of iatrogenesis, and warfarin was the drug that most commonly caused an adverse reaction. Inadequate follow-up of abnormal physical findings, symptoms, and laboratory test results was also important. Patients with preventable admissions had more medical diagnoses (4.9 versus 4.1, p <0.01), were prescribed more medications (4.5 versus 3.7, p <0.01), and were older (66.5 years versus 60.2 years, p <0.01) than patients whose admissions were not preventable. It is concluded that a small percentage of emergency hospitalizations may be preventable and that systematic review of emergency hospitalizations may provide a means of measuring the quality of primary medical care. © 1987.
  • Authors

    Published In

    Digital Object Identifier (doi)

    Author List

  • Bigby J; Dunn J; Goldman L; Barclay Adams J; Jen P; Seth Landefeld C; Komaroff AL
  • Start Page

  • 1031
  • End Page

  • 1036
  • Volume

  • 83
  • Issue

  • 6