Surgical Outcomes ResearchThe incidence and nature of surgical adverse events in Colorado and Utah in 1992ast;,**
Section snippets
Methods
We sought to provide a detailed analysis of surgical adverse events through a retrospective chart review of 15,000 randomly selected admissions to Colorado and Utah hospitals during 1992 with use of the techniques of previous adverse event studies.20 Specifically, in addition to estimating the incidence, morbidity, and preventability of surgical adverse events, we sought to characterize their distribution by type of injury and by physician specialty and to determine incidence rates by
Patient characteristics
We completed initial review of 14,700 of 15,000 records (98.0%) in the original random sample. Patients were 38.9 years old on average in our sample compared with 38.2 years for all discharges, women were 61% of our sample and 59% of all discharges, Medicare beneficiaries were 24% of both groups, Medicaid beneficiaries were 15% of both groups, the privately insured were 47% of our sample and 46% of all discharges, managed care enrollees were 8% versus 11%, and the uninsured were 6% versus 5%.
Discussion
Contrary to a perhaps-common perception, our study of hospitalized patients in Colorado and Utah in 1992 found that adverse events resulting in death, disability, or a prolonged hospital stay were no more likely to occur in surgical care than in nonsurgical care. Overall, such adverse events occurred in approximately 3% of admissions in the 2 states in 1992. How much the incidence of adverse events varies by region is unknown, but this could represent a decline from previous incidence rates of
Acknowledgements
We thank Dr John Orav for his advice on statistical analysis and Drs Lucian Leape and Jennifer Daley for their advice on preparing the manuscript.
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- ast;
Supported by the Robert Wood Johnson Foundation, Princeton, NJ. A. A. G. is supported by an Agency for Health Care Policy and Research postdoctoral fellowship award.
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Reprint requests: Atul A. Gawande, MD, Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.