Starting from the obvious observation of human fallibility, it is not surprising to have to point out that errors occur in all professional fields and, therefore, also in healthcare. A medical error is considered an “adverse event” when it causes harm to a patient.
According to the latest available data, released by the O.M.S. with the recent 2018 report on the quality of health services, 10% of patients experience an adverse event during health treatment. Ten out of a hundred patients, therefore, report an injury – more or less serious – as an unintended consequence of care practices. Of these ten patients, seven contract a hospital infection, which in 1% of cases will lead them directly to death.
So in our country, out of the approximately 9/10 million hospital admissions, almost a million patients are victims of a medical error every year; between them:
6/700 thousand patients report health care-related infections;
6/7 thousand patients die from causes directly attributable to the infection;
3 / 3.5 thousand of these deaths per year would be abstractly preventable.
These are estimates, of course. Because in Italy, in hindsight, there are no truly reliable statistics on medical-health errors.
The existing ones, in reality, would seem to testify due to a progressive measure of adverse health events, the consequent complaints and the compensatory amounts paid.
For example, the final report of the Parliamentary Commission of Inquiry into errors in the health field, established by a resolution of the Chamber of Deputies on November 5, 2008, highlighted that claims of claims had an increasing trend from 2006 to 2009, to then begin to decrease in the two-year period 2010-2011, to the point that the number of adverse events in 2011 returned to the value recorded in 2008.
The decrease in the amount of compensation paid by the Health Authorities concerned by the survey would be more marked: in 2011 there would have been a reduction of 75% compared to the sums paid in 2006 (from almost 200 million euros in 2006, to less than 50 million euros in 2011).
Also according to the Statistical Bulletin on health civil liability risks in Italy, released by the Institute for Insurance Supervision at the end of 2017, there was a net amount of claims for damages between 2010 and 2016. In particular, insurance companies received around 15,000 claims in 2016, compared to around 30,000 received in 2010.), both from the greater recourse of the Health Authorities to forms of self-restraint of health risk, with the consequent lack of insurance coverage.
These statistics, however, only account for cases in which there has been a complaint or a request for compensation by the patient or his relatives.
All other events remain in the shadows, essentially due to the traditional resistance of health workers to spontaneously report adverse events (very often for fear of the related repercussions).
Therefore, the actual number of errors occurring in healthcare is very difficult to identify. The only certain fact is that the events reported by the statistics are far lower than those actually occurred.
The hope is, then, that the rule that provides for the obligation for all public and private structures to activate an adequate health risk monitoring, prevention and management function (so-called risk management) can be fully implemented, in order to implement suitable monitoring and prevention paths for the most frequent critical issues in the health sector, pursuant to art. 1, paragraph 539, letter a), law 28 December 2015, n. 208.