Comments: Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital (volume 344, article number e832, 2012)

• We commend Wilson and colleagues1 for their excellent study providing valuable evidence on the frequency and nature of adverse events in hospitals in transitional economies. Wilson and colleagues defined an adverse event as “an unintended injury that resulted in temporary or permanent disability or death (including increased length of stay or readmission) and that was associated with healthcare management rather than the underlying disease”, and found that 8.2% of the 15 548 reviewed records included at least one adverse event. The most common adverse events were therapeutic errors (34% of all adverse events), diagnostic events (19%), and operation-related events (18%). Drug-related adverse events represented only 4% of all adverse events, and were present in 0.3% of all records. Thus, drug-related events were markedly less frequent than in western studies,2 as the authors acknowledge. Wilson and colleagues imply that less frequent use of medicines in transitional economies may contribute to fewer drug-related events, and argue that improvements are needed in the diagnostic and therapeutic steps in the care of patients.

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