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Quality and Safety in Health Care 2008;17:65-70; doi:10.1136/qshc.2006.021758
Copyright © 2008 by the BMJ Publishing Group Ltd.

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ORIGINAL ARTICLES

Patient race/ethnicity, age, gender and education are not related to preference for or response to disclosure

C Hobgood1, J H Tamayo-Sarver2, B Weiner3

1 Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
2 Department of Emergency Medicine, Harbor-University of California at Los Angeles Medical Center, Torrance, California, USA
3 Department of Health and Policy Administration, University of North Carolina School of Public Health, Chapel Hill, North Carolina, USA

Correspondence to:
Dr C Hobgood, Department of Emergency Medicine, University of North Carolina Chapel Hill, 101 Manning Drive, Chapel Hill, North Carolina 27599, USA; hobgood{at}med.unc.edu

Objective: The purpose of this study was to (a) characterise patients’ preferences for disclosure of medical errors and reporting, (b) assess patients’ responses to disclosure of error and (c) determine how these preferences differ by patient race/ethnicity, gender, age and level of education.

Methods: A survey was conducted of consecutive patients presenting at any hour to a tertiary care academic emergency department. Inclusion criteria were: >21 years, competent to conduct the interview (ie, conscious, not demented, delirious, intoxicated or undergoing a psychiatric evaluation), initial Glasgow Coma Scale >12, and patient not transferred from another institution and not in state custody. A four-scenario survey was used to assess patients’ preferences for: disclosure, reporting and responses to disclosure. The responses to the scenarios were analysed using Somers D. Independent effects of study variables were assessed with a generalised estimating equation.

Results: Of 512 eligible patients, 394 (77% response rate) participated, and 238/394 (61%) met the criteria for analysis. Overall, in 902 (98%) responses to the scenarios, participants wanted disclosure, in 404 (45%), they wanted the error reported and in 311 (35%) they were less likely to seek legal action if informed of the error. In all three categories there was no relation with race/ethnicity, gender, age and education, with the exception of an increased desire for reporting in younger patients and those with less education.

Conclusions: Interventions that aim to assist doctors with disclosure of medical error must emphasise the uniformity of patient preferences for disclosure and the diminished likelihood of legal action following disclosure.





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Int J Qual Health CareHome page
R. Iedema, R. Sorensen, E. Manias, A. Tuckett, D. Piper, N. Mallock, A. Williams, and C. Jorm
Patients' and family members' experiences of open disclosure following adverse events
Int. J. Qual. Health Care, September 17, 2008; (2008) mzn043v1.
[Abstract] [Full Text] [PDF]




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