Variability of adverse events in the public health-care service of the Tuscany region

The objective of the study is to analyze the variation of adverse events (AEs) according to the different structure of hospitals. The study is a multicenter, retrospective study. It involves 4 teaching hospitals (THs) and 32 community hospitals, distributed in 12 local trusts (LTs), of the Tuscany Regional Healthcare Service (RHS). A random sample of the clinical records of patients admitted in LTs and THs in 2008 was selected from the database of the hospital discharge records of the centers. Among 11,293 clinical records included, a total of 354 adverse events were identified. There was a significant higher incidence of AEs in the male and elderly (>65 years) population, and the incidence of AEs was more relevant in the THs (5.3, 95% CI 4.7–6.1) than in the LTs (1.8, 95% CI 1.5–2.2). AEs related to falls were significantly more preventable in THs (OR 19.22, 95% CI 2.45–151.02), while in LTs, AEs related to infections were the most preventable (OR 6.22, 95% CI 1.35–28.67). Concerning ...