Intention to disclose medical errors by healthcare providers to patients and associated factors in Ugandan health facilities: A cross-sectional study

Résumé

This study assessed the prevalence and factors associated with intention to disclose medical errors by healthcare providers to patients in public health facilities in Mukono District, Uganda. We conducted an analytic cross-sectional study among healthcare providers across four public health facilities in Mukono District, Uganda. The outcome, Intention to disclose medical errors to patients, was defined as self-reported likelihood of informing a patient or their caregiver about a medical error if it had occurred, including the circumstances of error occurrence and any corrective actions taken. Data were collected using a self-administered structured questionnaire capturing factors at the individual and institutional levels. Logistic regression analysis was used to identify factors independently associated with intention to disclose medical errors, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) reported. We studied 166 healthcare providers, of whom 90 (54.2%) were aged ≥35 years and 95 (57.2%) were female. Overall, 74 (44.6%) participants reported an intention to disclose medical errors. After adjusting for potential confounders, nurses (aOR 0.09, 95% CI 0.02-0.37) and other cadres (aOR 0.09, 95% CI 0.02-0.47) had significantly lower odds of intention to disclose medical errors compared with medical doctors/physicians. In contrast, healthcare providers working in health facilities with supportive supervision had higher odds of intention to disclose medical errors than those without supportive supervision (aOR 3.32, 95% CI 1.37-8.06). Fewer than half of healthcare providers have the intention to disclose medical errors to patients, indicating a substantial gap from the ethical expectation of full transparency. Supportive supervision was associated with an increased likelihood of intention to disclose medical errors, while non-physician cadres were less likely to report intention to disclose medical errors compared to medical doctors. Interventions that strengthen supervision and empower all cadres through training and institutional support may enhance openness and accountability in healthcare practice.

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