BACKGROUND Patient safety issues in primary health care and in emergency departments have not been as thoroughly explored as patient safety issues in the hospital setting. Knowledge is particularly sparse regarding which patients have a higher risk of harm in these settings. The objective was to evaluate which patient-related factors were associated with risk of harm in patients with reports of safety incidents. METHODS A case-control study performed in primary health care and emergency departments in Sweden. In total, 4536 patients (cases) and 44,949 controls were included in this study. Cases included patients with reported preventable harm in primary health care and emergency departments from January 1st, 2011 until December 31st, 2016. RESULTS Psychiatric disease, including all psychiatric diagnoses regardless of severity, nearly doubled the risk of being a reported case of preventable harm (odds ratio, 1.96; p < 0.001). Adjusted for income and education there was still an increased risk (odds ratio, 1.69; p < 0.001). The preventable harm in this group was to 46% diagnostic errors of somatic disease. CONCLUSION Patients with psychiatric illness are at higher risk of preventable harm in primary care and the emergency department. Therefore, this group needs extra attention to prevent harm.

中文翻译：

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与患者相关的因素与一线医疗中报告的可预防伤害的风险增加有关：一项病例对照研究。

背景技术与医院环境中的患者安全问题相比，初级卫生保健和急诊部门中的患者安全问题尚未得到充分探讨。关于哪些患者在这些情况下遭受伤害的风险更高的知识特别稀疏。目的是评估有安全事件报告的患者中哪些患者相关因素与伤害风险相关。方法在瑞典的初级卫生保健和急诊部门进行了病例对照研究。本研究共纳入4536例患者（病例）和44,949例对照。病例包括从2011年1月1日至2016年12月31日在初级卫生保健和急诊部门报告的可预防伤害的患者。结果精神病，包括所有精神病学诊断，不论严重程度，报告为可预防伤害的风险几乎增加了一倍（几率1.96； p <0.001）。经收入和教育调整后，风险仍然增加（优势比为1.69； p <0.001）。该组的可预防伤害是46％的躯体疾病诊断错误。结论精神病患者在初级保健和急诊科中可预防伤害的风险较高。因此，该小组需要格外注意以防止伤害。结论精神病患者在初级保健和急诊科中可预防伤害的风险较高。因此，该小组需要格外注意以防止伤害。结论精神病患者在初级保健和急诊科中可预防伤害的风险较高。因此，该小组需要格外注意以防止伤害。