User:Bluerasberry/Undesirable health care outcomes
Undesirable health care outcomes are all the unwanted results that can follow any person's seeking healthcare. Efforts to improve health care quality seek to reduce undesirable health care outcomes.
History of terminology
[edit]Acknowledging that bad things can result from health care has always been difficult. Assigning blame or causes for bad things related to health care also is taboo, and the health care industry is resistant to increasing their liability for problems without evidence to make this seem necessary. Because of this, the terminology for discussing types of health care problems has developed only recently.
In 1999 the Institute of Medicine published To Err is Human and solidified the concept of a "medical error".
Unpreventable outcomes
[edit]If a person receives healthcare, some bad outcomes will necessarily be part of the treatment and are expected.
Time in recuperation
[edit]Recovering from a health problem is good, but the goal of treatment is to minimize time in recuperation or convalescence so that a person can enjoy whatever quality of life they have after their treatment.
Side effects
[edit]In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequences of the use of a drug.
Occasionally, drugs are prescribed or procedures performed specifically for their side effects; in that case, said side effect ceases to be a side effect, and is now an intended effect. For instance, X-rays were historically (and are currently) used as an imaging technique; the discovery of their oncolytic capability led to their employ in radiotherapy (ablation of malignant tumours).
Complication
[edit]Complication, in medicine, is an unfavorable evolution of a disease, a health condition or a therapy. The disease can become worse in its severity or show a higher number of signs, symptoms or new pathological changes, become widespread throughout the body or affect other organ systems. A new disease may also appear as a complication to a previous existing disease. A medical treatment, such as drugs or surgery may produce adverse effects and/or produce new health problem(s) by itself. Therefore, a complication may be iatrogenic, i.e., literally brought forth by the physician.
Medical debt
[edit]Medical debt is different from other forms of debt, because it is usually incurred accidentally or faultlessly. People do not plan to fall ill or hurt themselves, and health care remedies are often unavoidable; medical debt is often treated with more sympathy than other kinds of debt resulting in advice that people ought not try to convert it to credit card debt.[1]
Preventable outcomes
[edit]Never events
[edit]A never event is a really bad mistake in health care which should never happen. Examples of never events include the performance of the wrong surgical procedure on a patient or having babies switched at birth in a hospital.
Adverse effect
[edit]In medicine, an adverse effect is an undesired harmful effect resulting from a medication or other intervention such as surgery.
In medicine, an adverse effect is an undesired harmful effect resulting from a medication or other intervention such as surgery.
An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. If it results from an unsuitable or incorrect dosage or procedure, this is called a medical error and not a complication. Adverse effects are sometimes referred to as "iatrogenic" because they are generated by a physician/treatment. Some adverse effects only occur only when starting, increasing or discontinuing a treatment.
Using a drug or other medical intervention which is contraindicated may increase the risk of adverse effects. Adverse effects may cause complications of a disease or procedure and negatively affect its prognosis. They may also lead to non-compliance with a treatment regimen.
An adverse drug reaction is a type of adverse effect.
Medical error
[edit]A medical error is a preventable adverse effect of care, whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, infection, or other ailment.
Unnecessary health care
[edit]Unnecessary health care, also called overutilization or overtreatment is when medical services are provided with a higher volume or cost than is appropriate.[2] Factors that drive overutilization include paying health care providers more to do more (fee-for-service) and covering patients' costs by a third-party (public or private insurance) payer.[3] These factors leave both doctors and patients with no incentive to restrain health care prices or use.[2][4]
Similarly, overtreatments are unnecessary medical interventions (therapies). They could be medical services for a condition that causes no symptoms and will go away on its own, or intensive treatments for a condition that could be remedied with very limited treatment. Overdiagnosis, when patients are given a diagnosis that will cause no symptoms or harm, can lead to overtreatment.
Loss of privacy
[edit]Health information is typically confidential information between the patient and their health care provider within the doctor–patient relationship. When a person's health information is disclosed beyond the patient, the patient may suffer a loss of privacy and face problems as a result.
Examples of social stigma resulting from the disclosure of personal health information include discrimination against persons seeking mental health treatment. Persons with HIV/AIDS may be targets of discrimination against people with HIV/AIDS and persons with leprosy may face leprosy stigma.
Patient abuse
[edit]Patient abuse or neglect is any action or failure to act which causes unreasonable suffering, misery or harm to the patient. It includes physically striking or sexually assaulting a patient. It also includes withholding of necessary food, physical care, and medical attention. It applies to various contexts such as hospitals, nursing homes, clinics and home visits.[5][dead link]
Other terms
[edit]"Preventable harm" has no consistent definition, but when used often means "presence of an identifiable, modifiable cause of harm".[6]
References
[edit]- ^ LESLEY ALDERMAN (2009-06-05). "When Medical Bills Outpace Your Means, Seize Control Swiftly". The New York Times. Retrieved 2009-06-22.
- ^ a b Ezekiel J. Emanuel & Victor R. Fuchs (June 2008). "The perfect storm of overutilization" (PDF). JAMA : The Journal of the American Medical Association. 299 (23): 2789–2791. doi:10.1001/jama.299.23.2789. PMID 18560006.
- ^ Ezekiel J. Emanuel & Victor R. Fuchs. "Health Care Overutilization in the United States—Reply". JAMA : The Journal of the American Medical Association. 300 (19): 2251. doi:10.1001/jama.2008.605.
- ^ Victor R. Fuchs (December 2009). "Eliminating 'waste' in health care". JAMA : The Journal of the American Medical Association. 302 (22): 2481–2482. doi:10.1001/jama.2009.1821. PMID 19996406.
- ^ http://doj.nh.gov/medicaid/whatispan.html[dead link]
- ^ Nabhan, Mohammed; Elraiyah, Tarig; Brown, Daniel R; Dilling, James; LeBlanc, Annie; Montori, Victor M; Morgenthaler, Timothy; Naessens, James; Prokop, Larry; Roger, Veronique; Swensen, Stephen; Thompson, Rodney L; Murad, M (2012). "What is preventable harm in healthcare? A systematic review of definitions". BMC Health Services Research. 12 (1): 128. doi:10.1186/1472-6963-12-128. ISSN 1472-6963.
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Further reading
[edit]- National Academy of Sciences (1 March 2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academies Press. Retrieved 12 June 2014.
- Agoritsas, Thomas; Bovier, Patrick A.; Perneger, Thomas V. (2005). "Patient reports of undesirable events during hospitalization". Journal of General Internal Medicine. 20 (10): 922–928. doi:10.1111/j.1525-1497.2005.0225.x. ISSN 0884-8734.
- Hibbard, J. H.; Jewett, J. J. (1996). "What Type of Quality Information do Consumers Want in a Health Care Report Card?". Medical Care Research and Review. 53 (1): 28–47. doi:10.1177/107755879605300102. ISSN 1077-5587.
- Hibbard, J. H.; Greene, J.; Daniel, D. (2010). "What Is Quality Anyway? Performance Reports That Clearly Communicate to Consumers the Meaning of Quality of Care". Medical Care Research and Review. 67 (3): 275–293. doi:10.1177/1077558709356300. ISSN 1077-5587.