Factors associated with harm in reported patient safety incidents and characteristics during health screenings in Korea: a secondary data analysis.

Abstract

Background: Various health screenings are conducted in South Korea, including state-supported national health screenings, privately funded comprehensive health screenings, and employment-related or industry-specific screenings. Given the various risks of patient safety incidents during the health screening process and the lack of studies of incidents in this environment, this study aimed to analyse the types and characteristics of reported patient safety incidents during health screenings, the distribution of harm, and the impact of the incident types on harm.

Methods: We analysed patient safety incidents reported to the Korean Institute for Healthcare Accreditation (2017-22) using the World Health Organization's framework for patient safety. We performed frequency analysis, chi-square tests, and binomial logistic regression analysis to identify the types and characteristics of reported patient safety incidents, the differences in the distribution of harm, and the impact of patient safety incident types on harm during health screenings.

Results: A total of 213 cases were included in the analysis. Over half of the patient safety incidents during health screenings resulted in harm to the patient, and examination-related incidents were the most frequent type of incident. Furthermore, reported patient safety incidents were more likely to occur during regular working hours, in the examination room, in hospitals with over 500 beds, and amongst patients in their 50s, with no significant differences in sex distribution. Significant differences were observed in the distribution of harm according to incident types (P <.001) and patient age (P =.023). Controlling for patient and incident characteristics, the incident type was a determinant of harm. Amongst the incident types, medication/drug administration [adjusted odds ratio (aOR) = 29.730, 95% confidence interval (CI) = 6.081, 145.368], anaesthesia/sedation/treatments and procedures (aOR = 5.121, 95% CI = 1.002, 26.178), falls (aOR = 4.903, 95% CI = 2.022, 11.890), infections/injuries (aOR = 11.898, 95% CI = 1.082, 130.839), and other types of incidents (aOR = 8.719, 95% CI = 2.602, 29.212) increased the probability of harm compared to examination-related incidents.

Conclusion: This study underscores the critical need to manage high-risk patient safety incidents and implement systemic harm reduction strategies during health screenings. Encouraging the reporting of incidents, including near misses, alongside developing targeted interventions, is essential for enhancing patient safety. Future research should leverage larger datasets, consistent classification systems, and standardized data collection to generalize findings and advance prevention strategies, thereby improving the quality and safety of health screening services.