BACKGROUND:This study compared the number ofcare-relatedinjuriesreported to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) with the number reported to 15 mandatory-reportingstates.METHODS:The primary outcome measure was the number ofpatientinjuriesreported to each in 1999.RESULTS:In all categories examined, the number of reports submitted by accredited hospitals to states equaled or exceeded the number reported to JCAHO.DISCUSSION:State-reportingsystemsidentified a greater number ofcare-relatedinjuriesthan did the JCAHO system. Although JCAHO received fewer reports from accredited hospitals, its process requires an analysis of the event and a prevention plan, and it disseminates the lessons learned from reported events. For adverse eventreportingto improvepatientsafety, there must be assurances that lessons are learned from these events, preventive measures are taken, and information is shared so others may benefit without having to experience the same adverse event.CONCLUSION:This study represents an early attempt to understand the system characteristics that influence hospitalreportingofcare-relatedpatientinjuries. Asreportingsystemsbecome more prevalent and standardized, the influence of factors such as legal protections, confidentiality, and technology onreportingshould be better understood.Comment onAre more reports better?[Jt Comm J Qual Saf. 2003]