Hospital ownership and preventable adverse events

OBJECTIVE: To determine if type of hospital ownership is associated with pr eventable adverse events. DESIGN:Medical record review of a random sample of 15,000 nonpsychiatric, n on-Veterans Administration hospital discharges in Utah and Colorado in 1992 . MEASUREMENTS AND MAIN RESULTS: A two-stage record review process using nurs e and physician reviewers was used to detect adverse events. Preventability was then judged by 2 study investigators who were blinded to hospital char acteristics. The association among preventable adverse events and hospital ownership was evaluated using logistic regression with nonprofit hospitals as the reference group while controlling for other patient and hospital cha racteristics. Wc analyzed 4 hospital ownership categories: nonprofit, for-p rofit, major teaching government (e.g., county or state ownership), and min or or nonteaching government. RESULTS: When compared with patients in nonprofit hospitals, multivariate a nalyses adjusting for other patient and hospital characteristics found that patients in minor or nonteaching government hospitals were more likely to suffer a preventable adverse event of any type (odds ratio [OR] 2.46; 95% c onfidence interval [CI], 1.45 to 4.20); preventable operative adverse event s (OR, 4.85; 95% CI, 2.44 to 9.62); and preventable adverse events due to d elayed diagnoses and therapies (OR, 4.27; 95% CI, 1.48 to 12.31). Patients in for profit hospitals were also more likely to suffer preventable adverse events of any type (OR, 1.57; 95% CI, 1.03 to 2.38); preventable operative adverse events (OR, 2.63; 95% CI, 1.42 to 4.87); and preventable adverse e vents due to delayed diagnoses and therapies (OR, 4.15; 95% CI, 1.84 to 9.3 4). Patients in major teaching government hospitals were less likely to suf fer preventable adverse drug events (OR, 0.38; 95% CI, 0.16 to 0.89). CONCLUSIONS: Patients in for-profit and minor teaching or nonteaching gover nment-owned hospitals were more likely to suffer several types of preventab le adverse events. Further research is needed to determine how these events could be prevented.