UCSF

Background: Disclosure of medical errors, in which a healthcare provider informs the patient/family of the error and takes responsibility, is an ethical imperative. Little is known about how medical error disclosure preferences or perceptions may vary for patients who are people of color, are older, or have lower educational attainment.

Methods: We conducted a narrative review around medical errors and disclosure. We included studies in high-income countries that included a predominantly marginalized population, defined by any one of the following: older age adults (mean age > 65 years); low educational attainment (> 55% of participants with less than a high school education); and/or racial/ethnic minority (< 55% of participants identifying as non-Hispanic white for US studies). We reported results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: The literature search yielded 3,050 articles, and we included six studies for analysis. Four studies used hypothetical vignettes; one used focus groups, and one used a survey. Three studies met our marginalized population criteria based on education; three met our criteria based on race/ethnicity. No study met our inclusion criteria for age. All six articles examined patient preferences for disclosure, and two studies also examined patient perceptions of disclosure. Overall, participants preferred that medical errors be disclosed to them. Most of the studies lacked multiple regression analysis to investigate differences in disclosure preferences by race/ethnicity, age, and education.

Conclusion: Participants from marginalized populations may have similar disclosure preferences to white and highly educated participants. Future studies should aim to examine differences in error disclosure preferences among patients who have experienced adverse events across race/ethnicity, educational attainment, and age.