Assessment of Medication Errors in Government vs. Private Hospitals of Islamabad and Rawalpindi
Keywords:
Administration errors, Hospital safety, Islamabad, Medication errors, Pakistan, Patient safety, Polypharmacy, Private hospitals, Public hospitals, Risk factorsAbstract
Background:
Medication errors represent a major and preventable threat to patient safety worldwide, with developing countries facing higher risks due to resource constraints and system inefficiencies. In Pakistan, data comparing error prevalence across different hospital sectors remain limited, particularly in the twin cities of Islamabad and Rawalpindi, where both government and private hospitals operate under distinct management structures.
Objective:
To assess and compare the prevalence, types, and determinants of medication errors in government and private hospitals of Islamabad and Rawalpindi, and to identify key risk factors contributing to their occurrence.
Methods:
A cross-sectional observational study was conducted in selected tertiary-care hospitals—two government and two private—over six months. A total of 310 inpatients and 1,278 medication exposures were evaluated using a validated audit tool covering prescribing, dispensing, administration, and documentation phases. Data were analyzed using SPSS v25. Descriptive statistics summarized error types and frequencies, and inferential tests (two-proportion Z-test and multivariable logistic regression) assessed differences and predictors, with significance set at p < 0.05.
Results:
Overall, 191 medication errors were identified (14.9% of exposures), with a significantly higher rate in government hospitals (17.8%) than private hospitals (12.4%) (p = 0.02). Administration errors predominated (46.6%), followed by prescribing (27.2%), documentation (13.6%), and dispensing errors (12.6%). Polypharmacy (≥ 5 medications; OR = 2.45, 95% CI 1.67–3.61) and longer hospital stay (≥ 7 days; OR = 1.78, 95% CI 1.11–2.87) were significant predictors. Night-shift administration accounted for 65% of administration errors.
Conclusion:
Medication errors are frequent in both hospital sectors, with a greater burden in government facilities. Strengthening medication safety protocols, staff training, and adoption of electronic systems are critical for minimizing preventable harm.
Keywords:
Administration errors, Hospital safety, Islamabad, Medication errors, Pakistan, Patient safety, Polypharmacy, Private hospitals, Public hospitals, Risk factors
