# Self-Reported Medical Errors and Primary Care Physicians’ Performance and Confidence in Delivering Care: A Multilevel Empirical Study in China

## TL;DR

This study explores how self-reported medical errors affect primary care physicians' performance and confidence in China.

## Contribution

It provides new empirical evidence on the impact of medical errors on physician performance and confidence in a developing country context.

## Key findings

- Self-reported medical errors are negatively associated with clinical and preventive care quality.
- Physicians' confidence in managing multimorbidity and mental health disorders is reduced by self-reported errors.
- Confidence in managing common diseases is not significantly affected by self-reported errors.

## Abstract

Background/Objectives: Patient safety is fundamental to primary healthcare, and medical errors impose a considerable burden on patients globally. However, the impact of medical errors on primary healthcare physicians remains understudied, especially in developing countries. This study aimed to examine the associations between self-reported medical errors and physicians’ performance and confidence in Chinese primary care practice. Methods: A cross-sectional survey was conducted from November 2021 to May 2022 with 224 primary care physicians from 38 community health centers (CHCs) across four large cities in China. The quality of clinical and preventative care, and confidence in managing commonly occurring diseases, multimorbidity, and common mental health disorders served as indicators of performance and confidence, respectively. Hierarchical linear regression and linear regression with cluster-robust standard errors were employed. Results: Clinical care quality (β = −0.159, SE = 0.075, p < 0.05), preventive care quality (β = −0.165, SE = 0.068, p < 0.05), confidence in managing multimorbidity (β = −0.175, SE = 0.074, p < 0.05), and confidence in managing common mental health disorders (β = −0.189, SE = 0.076, p < 0.05) were negatively associated with self-reported medical errors, with scores of 4.08 (SD 0.95), 3.59 (SD 0.87), 3.63 (SD 1.04), and 3.10 (SD 1.21) out of 5 (where 5 represents the best possible score), respectively. The association between self-reported medical errors and confidence in managing commonly occurring diseases (β = −0.063, SE = 0.075, p > 0.05) was not statistically significant, with a score of 3.81 (SD 1.00) out of 5 (where 5 represents the best possible score). Conclusions: This study offers new insight into the associations between self-reported medical errors and primary healthcare physicians’ performance and confidence. It is crucial for CHCs to be aware of the impact of self-reported medical errors on physicians’ performance in delivering clinic and preventative care, and confidence in managing multimorbidity and common mental health disorders. Strategies such as strengthening organizational support should be developed to maintain performance and rebuild confidence in delivering care for physicians who were involved in medical errors.