Definition of a Significant Medical Problem
A significant medical problem is a medical condition that is associated with morbidity that substantially impacts day-to-day functioning, threatens survival, or has a high likelihood of progression if left untreated, resulting in serious harm to the patient. 1
Key Characteristics of Significant Medical Problems
- A serious medical condition is one that significantly impacts daily function, survival, or has a high likelihood of progression if left untreated 1
- It may result in death, life-threatening situations, require hospitalization, prolong existing hospitalization, or cause persistent/significant disability 1
- Significant medical problems often represent unmet medical needs - conditions whose treatment or diagnosis is not adequately addressed by available therapy 1
Examples of Significant Medical Problems
Emergency medical conditions - conditions manifesting with acute symptoms of sufficient severity (including severe pain) such that absence of immediate medical attention could reasonably be expected to result in:
- Placing health in serious jeopardy
- Serious impairment to bodily functions
- Serious dysfunction of any bodily organ or part 1
Chronic conditions with substantial impact - diseases like osteoarthritis that reduce life expectancy and significantly impair mobility 1
Conditions causing serious adverse events - events that:
- Result in death
- Are life-threatening
- Require inpatient hospitalization or prolong existing hospitalization
- Result in persistent or significant disability/incapacity
- Represent a congenital abnormality or birth defect 1
Quantifying the Burden of Significant Medical Problems
- Diagnostic errors alone cause approximately 795,000 Americans to become permanently disabled or die annually 2
- Nearly one in four hospital admissions (23.6%) involves at least one adverse event, with approximately 6.8% experiencing preventable adverse events 3
- Around 6% of patients experience preventable harm in medical care settings, with 12% of these harms being severe or fatal 4
Categories of Significant Medical Problems
- Vascular events - such as stroke, which accounts for a substantial portion of serious diagnostic errors 2
- Infections - including sepsis and pneumonia, which represent major sources of preventable harm 2
- Cancers - particularly lung cancer, which is among the top five conditions associated with serious diagnostic errors 2
- Adverse drug events - accounting for 39% of all adverse events in hospital settings 3
- Surgical or procedural events - representing 30.4% of hospital adverse events 3
- Self-harm - associated with greatly increased risk of premature death (3.6 times higher in the first year after an episode) 5
Clinical Implications
- The identification and proper management of significant medical problems is critical as they represent major causes of morbidity and mortality
- Despite extensive efforts to improve patient safety over the past decades, harms remain common with little evidence of widespread improvement 6
- Clinicians should be particularly vigilant about conditions that may lead to serious harm, especially those that are commonly misdiagnosed or associated with preventable adverse events 2
- Early intervention for significant medical problems is essential, as many conditions show particularly high mortality in the first year after diagnosis 5