Professional and physician-rank differences in submitted patient safety incident reports: a retrospective cross-sectional analysis of a hospital reporting database

Abstract Background Voluntary patient safety incident-reporting systems support organizational learning but capture only a selected subset of patient safety events. Although previous studies have identified differences in the characteristics of reports submitted by different healthcare professions, physicians have generally been treated as a single professional group. This study examined the composition and severity-field completion of submitted reports across professional groups and physician ranks. Methods We conducted a single-center retrospective cross-sectional study of eligible patient safety incident reports submitted to a tertiary general hospital between January and December 2025. Event-type composition, recorded severity distribution, and severity-field completion were compared across nurses, physicians, and pharmacists and across junior, intermediate, and senior physicians. Pearson’s χ² tests were used for group comparisons, Cramér’s V was reported as the effect-size measure, and selected proportions were accompanied by Wilson 95% confidence intervals. Results A total of 7,218 submitted reports were analyzed. Nurses accounted for 57.23% of reports (95% CI, 56.09%-58.37%), physicians for 38.89% (37.77%-40.02%), and pharmacists for 3.88% (3.46%-4.35%). Overall, 64.95% of reports lacked a recorded severity category (95% CI, 63.84%-66.04%) and were classified as Unclassified. Profession was strongly associated with event-type composition (Cramér’s V = 0.753) and severity-field completion (V = 0.651). Among physician-submitted reports, the associations of physician rank with recorded severity distribution (V = 0.107) and event-type composition (V = 0.081) were statistically significant but small. Conclusions The composition and severity-field completion of submitted reports differed across healthcare professions, whereas differences across physician ranks were relatively small. These findings do not estimate profession- or rank-specific reporting rates, reporting propensity, or the true incidence of patient safety events. The high and profession-dependent proportion of Unclassified reports supports clearer severity-classification guidance, profession- and career-stage-sensitive training, and review of reporting workflows and responsibility for final severity assignment.