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Vol. 36. Issue 6.
Pages 340-344 (November - December 2021)
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Vol. 36. Issue 6.
Pages 340-344 (November - December 2021)
Original article
Frequency of outpatient care adverse events in an occupational mutual insurance company in Spain
Frecuencia de eventos adversos en la atención ambulatoria de una Mutua colaboradora de la Seguridad Social en España
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J. Ortnera,
Corresponding author
jortner@mc-mutual.com

Corresponding author.
, A. Vivesa, D. Moyaa, M. Torresa, N. Graua, X. Farrúsa, R. Manzaneraa, J.J. Mirab,c
a MC Mutual, C/ Provença, 321, 08037 Barcelona, Spain
b Universidad Miguel Hernández, Avinguda de la Universitat d’Elx, s/n, 03202 Elche, Alicante, Spain
c Departamento de Salud de Alicante-Sant Joan, Alicante, Spain
Article information
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Tables (2)
Table 1. Frequency, nature, preventability and specific causality of adverse events.
Table 2. Preventability and severity of Adverse Events.
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Abstract
Background

Occupational mutual insurance companies (OMICs), in collaboration with the Spanish Social Security System, provide healthcare and manage the economic benefits for the workers in Spain. They have ambulatory care centers that attend outpatient trauma pathology, although most of the studies published have focused on surgical and hospital activity.

The aim of this study was to detect adverse events (AEs) in outpatient trauma care in the context of an OMIC.

Methods

A cohort study designed to identify harmful safety incidents (adverse events, AEs) in 2017 was conducted. A random sample of 313 medical records among patients who were visited more than 3 medical and nursing attendances during their outpatient process. The AEs detected were classified according to category, severity and preventability.

Results

We identified 48 AEs (15.3% of medical records, 95% CI 11.3–19.3), most of them procedure-related, while 27 (56.2%) were preventable and 46 mild (95.8%).

Conclusions

The AEs identified are double than those found in primary care general consultations in Spain and are close to the lower range of studies on surgical AEs in traumatology and orthopedics. Preventable AEs were within expected limits. Over half of AEs are preventable, within that group, the mild AEs have an increased rate of preventability. These results highlight the relevance of research of patient safety in the outpatient care of trauma and orthopaedic procedures in an OMIC for patient safety and contribute to introduce improvements in outpatient care.

Keywords:
Safety patient
Adverse events
Adverse effects
Medical errors
Occupational Health Services
Quality of health care
Resumen
Antecedentes y objetivo

Las Mutuas colaboradoras con la Seguridad Social gestionan las prestaciones sanitarias y económicas de la Seguridad Social para los trabajadores en España. Disponen de centros que atienden patología traumatológica ambulatoria poco conocidos en la bibliografía que se han centrado en la actividad quirúrgica y hospitalaria.

El objetivo de este estudio fue la detección de eventos adversos (EA) en la atención traumatológica ambulatoria en el contexto de una mutua laboral.

Materiales y Métodos

Se desarrolló un estudio retrospectivo, observacional, descriptivo diseñado para identificar incidentes de seguridad con daño (EA) en 2017. Se analiza una muestra aleatoria de 313 historias clínicas de pacientes con más de tres atenciones médicas y de enfermería durante su proceso ambulatorio. Los EA detectados fueron clasificados según categoría, gravedad y evitabilidad.

Resultados

Se identificaron 48 EA (15,33% de historias clínicas, IC 95% 11,3-19,3), la mayoría relacionados con procedimientos, 27 (56,2%) se consideraron evitables y 46 leves (95,8%).

Conclusiones

Los EA identificados multiplican por dos los hallados en los pacientes generales visitados en la atención primaria en España y se aproximan a la horquilla inferior de los estudios sobre EA quirúrgicos de traumatología y ortopedia. La evitabilidad es similar a la observada en otras series (en torno al 50%). Estos resultados ponen de manifiesto la situación, apenas estudiada hasta ahora, de la seguridad de pacientes en el caso de la atención ambulatoria traumatológica y ortopédica en una mutua laboral y contribuyen a la incorporación de mejoras en la atención ambulatoria.

Palabras clave:
Seguridad del paciente
Eventos adversos
Efectos adversos
Errores médicos
Mutuas laborales
Calidad asistencial

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