How do patients respond to safety problems in ambulatory care? Results of a retrospective cross-sectional telephone survey

OBJECTIVES: Patients in German ambulatory care frequently report patient safety problems (PSP). It is unclear whether patients report PSP back to their general practitioner (GP) or specialist in charge. This study reports on how patients respond to experienced PSP. DESIGN: Retrospective cross-sectional study. SETTING: Computer-assisted telephone interviews (CATI) with randomly recruited citizens aged ≥40 years in Germany. PARTICIPANTS: 10 037 citizens ≥40 years. About 52% of the interviewees were female, 38% were between 60 and 79 years old and about 47% reported that they were chronically ill. A total of 2589 PSPs was reported. PRIMARY AND SECONDARY MEASURES/RESULTS: According to the respondents (n=1422, 77%, 95% CI: 74.7 to 79.1), 72% (95% CI: 70.2 to 73.7) of PSP were reported back to the GP in charge or to another GP/specialist. Further reactions were taken by 65% (95% CI: 62.5 to 67.5) of the interviewees: around 63% (95% CI: 62.5 to 66.2) of the reported PSP led to a loss of faith in the physician or to complaints. χ(2) and binary logistic regression analyses show significant associations between the (a) reporting and (b) reaction behaviour and determinants like ‘medical treatment area’ ((a) χ(2)=17.13, p=0.009/(b) χ(2)=97.58, p=0.000), ‘PSP with/without harm’ ((a) χ(2)=111.84, p=0.000/(b) χ(2)=265.39, p=0.000) and sociodemographic characteristics when respondents are aged between 40 and 59 years ((a) OR 2.57/(b) OR 2.60) or have chronic illnesses ((a) OR 2.16/(b) OR 2.14). CONCLUSION: The data suggest that PSPs are frequently reported back to the GP or specialist in charge and have a significant serious impact on the physician–patient relationship. Much could be learnt from the patient reporting and reacting behaviour to prevent PSPs in ambulatory care.