Public Attitudes and Opinions on Medical Errors in India

Baldwin JL, Bhise V, Sadana A, Singh H. Public Attitudes and Opinions on Medical Errors in India. Poster session presented at: Diagnostic Error in Medicine Annual International Conference; 2016 Nov 7; Hollywood, CA.

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Background Improving patient safety in developing countries faces several challenges, including the lack of a comprehensive healthcare delivery system that invests in resources to improve safety. Public opinion about medical errors could be an important driver for making changes. We surveyed community members in India to gather information on their knowledge and opinions related to medical errors, including diagnostic errors. Methods We designed a web-based survey, using a previously validated structured survey instrument that captured patient perceptions of medical errors(Patient Views of Public Health in Massachusetts, Harvard School of Public Health). Survey items consisted of closed-ended questions to understand participant's familiarity and past experiences with medical errors. The survey was sent to a convenience sample of members of a community organization. Participants, who were familiar with errors, were asked additional questions about contributing factors and perceived seriousness of medical errors. SurveyMonkey was used to administer the survey to a convenient sample of adult patients in India from April 2015 to October 2015. Descriptive analyses are reported here. Results Thus far, 52 participants have responded. In preliminary analyses, most participants(73.1%,n = 38) were familiar with the term medical error. Of these participants, most had heard or read news reports about the occurrence of medical errors and patient injuries in Indian hospitals over the last year(57.9%,n = 22), and considered them a very serious or a somewhat serious problem(55.3%,n = 21). Most participants felt they were likely to experience a medical error when receiving healthcare in India(47.4%,n = 18), and believed there were big differences in the frequency of such errors between different hospitals. Participants attributed most medical errors to poor physician and nurse training(68.4%,n = 26), overworked and tired medical personnel(65.8%,n = 25) and unclear follow-up instructions from the provider(65.8%,n = 25). Most participants(63.2%,n = 24) felt that over half of medical errors could be prevented. Over one-third(39.5%,n = 15) personally experienced a preventable error or knew someone who experienced one, with serious health consequences(66.7%,n = 10). Additionally, one-third(33%,n = 5) of these errors were diagnostic errors. Most of these errors occurred in the hospital(66.7%,n = 10), were not communicated to the participant(80.0%,n = 12) and were not reported by the participant to the hospital, doctor, nurse or an official agency(80.0%,n = 12). Conclusion Our study seeks to understand the current state of knowledge and awareness of medical errors in India. Our preliminary findings suggest medical errors are perceived to occur very frequently in Indian healthcare settings and diagnostic errors appear to be common. This work will help garner support for increased health professional and statewide public policy action in this area.