Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot12610.32687/0869-866X-2019-27-4-408-413Научная статьяThe safety of patients and related unfavorable occurrences in medicine: the systematic reviewVoskanyanYu. E.voskanyanue_mmch@mail.ruThe Federal State Budget Educational Institution of Additional Professional Education “The Russian Medical Academy of Continuous Professional Education” of Minzdrav of Russia1512201927440841306042021Copyright © 2019,2019The article presents an analysis of retrospective and prospective studies devoted to the study of patient safety in terms of epidemiology, frequency and severity of adverse events associated with medical care. The search was performed from 1990 to 2017 with the use of databases MEDLINE, Cochrane Collaboration; EMBASE; SCOPE; ISI Web of Science; WHO (official site); Meduniver; Nealthfulsite; Medpro. Meta-analysis of the obtained data allowed to establish the following. Medical errors in the provision of medical care are registered in 20.2% of patients, and cases of harm (adverse events) - in 10.6% of patients. More than 80% of adverse events occur in hospital. More than half of the cases of harm are registered in the operating room and about a third - in the patient’s room. When providing medical care outside hospital the main part of cases of harm are registered in the doctor's office and at home. The majority of adverse events are related to surgery, manipulations, drug therapy, late or incorrect treatment and diagnosis. Unexpected death is observed in 5.3% of patients with adverse events. In the structure of hospital mortality, the proportion of deaths related to medical care is 24.9%, and in the structure of the total mortality of the population it is 9.7%, ranking third among all causes.medical carepatient safetyadverse eventincidentmedical errorsunexpected deathмедицинская помощьбезопасность пациентанеблагоприятные событияинцидентмедицинские ошибкинеожиданная смерть1.WHO/World health statistics 2017: monitoring health for the SDGs, Sustainable Development Goals.2.Кондратова Н. В. Система безопасности и предотвращения ошибок: от авиации к медицине. Вестник Росздравнадзора. 2016;(2):22-6.3.Лудупова Е. Ю. Врачебные ошибки. Литературный обзор. Вестник Росздравнадзора. 2016;(2):6-15.4.Baker G. R., Norton P. G., Flintoft V., Blais R., Brown A., Cox J., et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ. 2004 May 25;170(11):1678-86.5.Davis P, Lay-Yee R., Briant R., Ali W., Scott A., Schug S. Adverse events in New Zealand public hospitals I: occurrence and impact. NZMJ. 2002 Dec 13;115(1167):1-9.6.Zegers M., Bruijne M. C., Wagner C., Hoonhout L. H. F., Waaijman R., Smits M., et al. Adverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study. Qual. Saf. Health Care. 2009;18:297-302.7.Wanzel K. R., Jamieson C. G., Bohnen J. M. A. Complications on a general surgery service: incidence and reporting. CJS. 2000 Apr;43(2):113-7.8.Wilson R. M., Runciman W. B., Gibberd R. W., Harrison B. T., Newby L., Hamilton J. D. The quality in Australian health care study. Med. J. Aust. 1995;163:458-71.9.Andrews J. M., Remon C. A., Burillo J. V., Lopez P. R. National Study on Hospitalisation-Related Adverse Events ENEAS 2005. Quality Plan of National Health System. Report Feb 2006.10.Brennan T. A., Leap L. L., Larid N. M., Hebert L., Localio A. R., Lawthers A. G., et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. N. Engl. J. Med. 1991;324:370-6.11.Thomas E. J., Studdert D. M., Burstin H. R., Orav E. J., Zeena T., Williams E. J. Incidence and types of adverse events and negligent care in Utah and Colorado. Med. Care. 2000;38(3):261-71.12.Leap L. L., Brennan T. A., Nan Laird M. P. H., Lawthers A. G., Localio A. R., Barnes B.AThe Nature of Adverse Events in Hospitalized Patients. Results of the Harvard Medical Practice Study II. N. Engl. J. Med. 1991;324:377-84.13.Vincent C., Neale G., Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ. 2001;322(7285):517-9.14.Deilkas E. T., Bukholm G., Lindstrøm J. C., Haugen M. Monitoring adverse events in Norwegian hospitals from 2010 to 2013. BMJ Open. 2015;5:1-6.15.Makary M. A., Daniel M. Medical error - the third leading cause of death in the US. BMJ. 2016;353(3):1-5.