Observational study finds duplicate medical records associated with increased hospital death risk — Evidence Review

Patients with duplicate medical records face a fivefold increased risk of death during hospitalization, according to new research published in the journal BMJ Quality & Safety. Related studies generally support the finding that accurate, unified health records are critical for patient safety and care quality.

• Prior research highlights the widespread nature of duplicate or mismatched records in electronic health record (EHR) systems and underscores the risks they pose for patient identification and continuity of care 1 6.
• Studies consistently find that poor data management and inaccurate documentation can contribute to medical errors, delayed care, and adverse outcomes, supporting the new study’s call for improved safeguards 2 6.
• While there is broad agreement that high-quality, integrated health records minimize errors and improve outcomes, some research also notes that specific impacts—such as direct links between duplicate records and mortality—require further investigation, a gap addressed by this new study 1 6.

Study Overview and Key Findings

Accurate health record management has become increasingly important as hospitals rely more on electronic systems to track patient information. This study addresses a significant gap by quantifying the risks associated with duplicate medical records, a problem estimated to affect 5–10% of patients. The findings are particularly timely as healthcare systems continue to expand and integrate digital records, raising concerns about patient safety and data integrity.

Property	Value
Study Year	2026
Journal Name	BMJ Quality & Safety
Authors	Gavriel Roda, Angela Keniston, Nicholas Wood, Hillary Western
Population	Adults up to age 89 admitted to hospitals
Sample Size	n=6086
Methods	Observational Study
Outcome	Inpatient death, intensive care admission, hospital stay length
Results	Patients with duplicate records had 5x higher death risk

The study analyzed over 6,000 adult inpatient records from 12 hospitals in a large U.S. health system. After matching patients on key characteristics, researchers found that those with duplicate records were nearly five times more likely to die during their hospital stay and over three times more likely to require intensive care compared to those with unified records. Additionally, hospital stays were 32% longer for patients with duplicate records. The authors suggest that fragmentation of records can lead to missing or inaccessible critical health information, delays in care, and increased risk of medical errors.

While the study is observational and cannot establish causality, it highlights an important association between data fragmentation and patient harm, calling for urgent improvements in health information management.

Literature Review: Related Studies

To place these findings in context, we searched the Consensus database, which includes over 200 million research papers. The following search queries were used to identify relevant literature:

1. duplicate medical records hospital death risk
2. medical record accuracy patient outcomes
3. hospital mortality duplicate record prevalence

Below, we organize key findings from related studies into high-level topics:

Topic	Key Findings
How do duplicate or inaccurate records affect patient safety and outcomes?	- High rates of duplicate or mismatched records are linked to increased patient identification errors and potential harm 1. - Poor documentation and fragmented records impede continuity of care and have been associated with increased incidence of medical errors and adverse outcomes 2 6.
What is the prevalence and nature of duplicate records in healthcare systems?	- Duplicate or matching identifiers in EHRs are common, with some institutions reporting up to 15% of records affected, highlighting the scale of the issue 1. - There is wide variability in how institutions detect and manage duplicates, with inconsistent adoption of prevention and mitigation strategies 1.
How does the quality of medical documentation impact care delivery?	- Inaccurate or incomplete nursing and clinical documentation is prevalent, particularly regarding interventions, and can reduce the quality and safety of care 2. - Accurate and standardized documentation is critical for effective care delivery and evaluation 2 6.
What role do EMRs/EHRs play in improving patient outcomes and reducing errors?	- High-quality EHR systems, when properly implemented, reduce medical errors and improve care by enabling better data integration and access 4 6. - However, data from unaudited or poorly managed registries can still be highly accurate for key outcomes, suggesting the importance of ongoing quality assurance 5.

How do duplicate or inaccurate records affect patient safety and outcomes?

Research consistently indicates that duplicate or inaccurate records compromise patient safety. The new study’s finding of increased inpatient mortality and intensive care needs among patients with duplicate records aligns with prior literature, which identifies patient identification errors and fragmented information as critical contributors to medical errors and adverse outcomes 1 2 6. The present research builds on this evidence by directly linking duplicate records to measurable increases in hospital mortality and critical care interventions.

• Duplicate or mismatched records may result in clinicians lacking vital information at the point of care, increasing the risk of errors 1 6.
• Poor or incomplete documentation can delay treatment and lead to inappropriate interventions 2.
• The integration of comprehensive and accurate patient data is associated with improved safety and outcomes 6.
• The new study fills a gap by quantifying the mortality and ICU admission risks directly associated with duplicate records, a link previously suggested but not robustly measured 1 6.

What is the prevalence and nature of duplicate records in healthcare systems?

Large healthcare systems frequently encounter duplicate records, with some reporting prevalence rates as high as 15%. Variability in detection and prevention strategies across institutions suggests that the problem is systemic but inconsistently managed 1. The new study’s estimate that 5–10% of patients are affected fits within this previously reported range.

• Matching identifiers (names, dates of birth) are a common source of duplicate records 1.
• There is significant variation in institutional policies for preventing and resolving duplicates 1.
• The scale of the issue underscores the need for standardized, system-wide approaches to data integrity 1.
• The new study highlights the clinical consequences of a problem that has been primarily viewed as administrative 1.

How does the quality of medical documentation impact care delivery?

Accurate and complete medical documentation is fundamental to safe, effective care. Inaccurate or incomplete records, especially regarding interventions, have been widely reported and are associated with gaps in care and evaluation 2. The present study highlights the downstream risks—such as prolonged hospital stays and higher readmission rates—when documentation is fragmented due to duplicate records.

• Nursing documentation, particularly of interventions, is often inaccurate or incomplete, which may compromise care 2.
• Admissions data tend to be more accurate, but there is substantial room for improvement in other documentation domains 2.
• Effective systems that link diagnoses, interventions, and outcomes are needed to support high-quality care 2 6.
• The consequences of poor documentation extend beyond administrative inefficiency to tangible impacts on patient outcomes 2 6.

What role do EMRs/EHRs play in improving patient outcomes and reducing errors?

Electronic health records have enabled large-scale outcomes research and improvements in care quality, but only when data are accurately integrated. High-quality EHR systems can minimize errors, but the persistence of duplicate or fragmented records undermines these benefits 4 6. The new study’s findings reinforce the necessity of data integrity for EHRs to fulfill their potential.

• EHRs support more efficient, accurate, and safe care delivery when well-managed 4 6.
• Data validation and quality assurance are essential to maintain reliable outcomes reporting 5.
• Even robust registries can harbor inaccuracies if not regularly audited, highlighting the need for ongoing process improvement 5.
• The effectiveness of EHRs in reducing errors depends on eliminating data fragmentation, as emphasized by the new study 6.

Future Research Questions

While the new study provides important insights, further research is needed to clarify causality, address system-level interventions, and understand broader implications. Key areas for further investigation include the mechanisms by which duplicate records lead to harm, best practices for prevention, and the impact of data integration strategies across diverse healthcare settings.

Research Question	Relevance
What specific mechanisms link duplicate medical records to higher inpatient mortality?	Understanding the causal pathways—such as missed allergies, medication errors, or delays in care—will inform targeted interventions 1 6.
How effective are different institutional strategies in preventing and resolving duplicate records?	Evaluating and comparing strategies across diverse settings can identify best practices and inform policy recommendations 1.
Does improving medical record accuracy reduce adverse outcomes in real-world settings?	Interventional or longitudinal studies are needed to determine whether enhancing data accuracy directly translates to lower mortality and morbidity 2 6.
What is the prevalence of duplicate records in different healthcare systems internationally?	Comparative data can reveal whether the problem varies by country, system design, or technology, guiding global efforts 1.
How do patients’ access to their own health records influence data accuracy and outcomes?	Enabling patients to review and correct their records may enhance accuracy and safety, but evidence on its effectiveness is mixed and needs further study 3.