Adverse events in outpatient services within Spain's occupational health insurance sector

Abstract

Background

This study examines the annual rate and nature of adverse events (AEs) in outpatient services within Spain's occupational health mutual insurance system. The pathologies treated are related to workplace accidents and occupational diseases, primarily trauma and musculoskeletal injuries. Since these mutual insurance entities provide essential care for work-related injuries and illnesses, identifying safety incidents can help improve care quality and reduce workplace disruptions caused by medical errors.

Methods

The study employed a retrospective observational design, analyzing new cases, during the year 2023, from 280 randomly selected patient records from five occupational health mutuals, which collectively cover approximately 42% of Spain's protected working population (up to 8.3 million workers). The analysis focused exclusively on outpatient healthcare activities. The data collected included demographic details, the severity and preventability of AEs, and associated causal factors.

Results

A total of 11 AEs were detected, resulting in an overall annual incidence rate of 39 per 1000 patients (95% CI: 21–71‰). Of these, 10 (90.9%) were deemed preventable. Most AEs were categorized as mild (10, 90.9%), with the primary causes linked to diagnostic errors, deficiencies in information management, and medication administration issues.

Conclusion

While most AEs were mild, approximately 10 per 1000 new AEs had more severe consequences requiring additional medical treatment. The high preventability rate indicates specific areas for improvement, such as targeted safety training for professionals, improved communication strategies with patients, and systems to monitor high-risk cases.