Comparative Study of Medical Errors Among Healthcare Workers in Urban and Suburban Healthcare Settings in Edo State, Nigeria

Background: Medical errors are a major global public health concern, leading to significant patient harm and economic losses. The distribution and determinants of these errors are influenced by the healthcare context, with urban and rural/suburban facilities facing distinct challenges. In Nigeria, patient safety remains under-researched, with little comparative data on medical errors across different settings. This study aimed to fill this gap by comparing the awareness, perception, prevalence, and determinants of medical errors among healthcare workers in urban and suburban facilities in Edo State, Nigeria.  Methods: A comparative descriptive cross-sectional study was conducted from October 2023 to March 2024 among healthcare workers in University of Benin Teaching Hospital (UBTH), an 860-bed tertiary facility in Benin City, and Igbinedion University Teaching Hospital (IUTH) with associated PHCs in Okada, a suburban community. A structured, pretested questionnaire adapted from WHO’s Patient Safety Assessment Tool was administered to 485 participants (235 urban, 250 suburban). Data were analyzed using SPSS v25. Chi-square tests assessed associations, and binary logistic regression identified predictors of medical errors. A p-value < 0.05 was considered significant.  Results: Significant differences were found in sociodemographic characteristics, with urban facilities having more doctors and early-career professionals, while suburban facilities had more nurses and mid-career professionals. A positive perception of medical errors was significantly higher among suburban healthcare workers (57.9% vs. 42.1%; OR=4.85). However, the self-reported experience of committing (53.1% vs. 46.9%) and witnessing (53.6% vs. 46.4%) errors was higher in the urban facility. Urban workers more frequently reported communication and procedural errors, while errors were perceived as more "frequent" in urban settings. Key determinants like lack of training, equipment failure, and insufficient protocol standardization were more pronounced in suburban facilities. Logistic regression identified increasing age (OR=1.049, p=0.012) as a significant predictor of errors, and nurses were less likely to report errors compared to pharmacists (OR=0.303, p=0.001).  Conclusion: Medical errors are a significant challenge in both settings, but their nature and underlying factors differ. The urban tertiary center reported a higher frequency of errors linked to system complexity, while suburban facilities were more affected by systemic resource and training gaps. Interventions to enhance patient safety must be context-specific, focusing on improving communication and procedures in urban areas and strengthening training, equipment, and standardized protocols in suburban areas.