Melbourne: Therapeutic Guidelines; 2004.
72 pages. Price including GST $33; students $25.30; plus postage

This book is a consumer view of medical adverse events, patient participation in healthcare decision-making, risk perception and patient safety in the Australian healthcare system. It is based on an analysis of the Australian Patient Safety survey which was a comprehensive study of Australians' attitudes to participation in health care and perceptions of safety. The book explains the likelihood and types of medical adverse events, models of consumer involvement in healthcare decision-making and the views of consumers about the safety of health services.

Medicine-related adverse events are the main category of adverse events reported, but the lack of resources and the exposure to infection were the most important consumer issues in relation to safety. Chapter 5 discusses the factors which predict adverse events. It is interesting that consumers perceived nursing homes, residential aged care, hospitals and doctors' surgeries as places where adverse events were likely to occur.

Younger people aged 18–34 years are significantly more likely to report an adverse event than the older age groups. According to the author, this may be due to younger people feeling more empowered in healthcare decision-making, but more data are needed to clarify why this is the case.

The final chapter of the book attempts to place the findings of the study within a policy context. A key finding is that the lack of resources and exposure to infection have contributed to a recent fall in confidence in relation to the safety of health care. Another finding with implications for health policy is consumers' preference for a shared decision-making model. Sharing information reduces the risk of experiencing an adverse event.

The book concludes that the value of this Australian study is that future studies may be able to focus on vulnerable groups. These include people with poor health and those who have a number of hospital admissions.

I can recommend this book to all those interested in consumer perceptions of risk, safety and quality and participation in health care. It will also be valuable to those interested in greater consumer participation in the policy, planning, delivery and evaluation of health care.

Janette Donovan

Consumer Class Director, Board of the National Prescribing Service, Sydney