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A Patient-Reported Spectrum of Adverse Health Care Experiences: Harms, Unnecessary Care, Medication Illness, and Low Health Confidence

Wasson, John H. MD

The Journal of Ambulatory Care Management: July/September 2013 - Volume 36 - Issue 3 - p 245–250
doi: 10.1097/JAC.0b013e3182955b22
New Feature: Snapshots of Patient Engagement

As part of a health “checkup,” a large national sample of adults used an Internet technology that also asks about adverse experiences. About half of all respondents do not feel very confident they can manage and control most of their health problems, almost 30% consider that their hospital or emergency department use was unnecessary, 20% believe that their medications may be causing illness, and 1.5% report a medical-related harm. Routine measures across a spectrum of adverse experiences are easy to obtain as part of everyday practice. Attention to these measures by health professionals should make care safer and less wasteful.

The Dartmouth Institute, Lebanon, New Hampshire.

Correspondence: John H. Wasson, MD, The Dartmouth Institute, 46 Centerra Parkway, Lebanon, NH 03766 (

The author thanks David Squires of the Commonwealth Fund for the international analysis of health confidence and Heidi Gill and Michael Lepore of the PlaneTree Alliance for the comparative data of patient self-reported and scored health confidence data.

John Wasson is the President of FNX Corporation, which distributes under license with the Trustees of Dartmouth College the Internet tool used to examine the patient-reported adverse experiences that are the basis for this report.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins