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Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Costs associated with adverse events among acute patients

Authors: Jakob Kjellberg, Rasmus Trap Wolf, Marie Kruse, Susanne R. Rasmussen, Jesper Vestergaard, Kent J. Nielsen, Kurt Rasmussen

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

The aim of this study was to analyse the additional treatment costs of acute patients admitted to a Danish hospital who suffered an adverse event (AE) during in-hospital treatment.

Methods

A matched case-control design was utilised. Using a combination of trigger words and patient record reviews 91 patients exposed to AEs were identified. Controls were identified among patients admitted to the same department during the same 20-month period. The matching was based on age, gender, and main diagnosis. Cost data was extracted from the Danish National Cost Database for four different periods after beginning of the admission.

Results

Patients exposed to an AE were associated with higher mean cost of EUR 9505 during their index admission (p = 0.014). For the period of 6 months from the beginning of the admission minus the admission itself they were associated with higher mean cost of EUR 4968 (p = 0.016). For the period from the 7th month until the end of the 12th month there was no statistically significant difference (p = 0.104). For the total period of 12 month, patients exposed to an AE were associated with statistically significant higher mean cost of EUR 13,930 (p = 0.001).

Conclusions

AEs are associated with significant hospital costs. Our findings suggest that a follow-up period of 6 months is necessary when investigating the costs associated with AEs among acute patients. Further research of specific types of AEs and the costs of preventing these types of AEs would improve the understanding of the relationship between adverse events and costs.
Literature
1.
go back to reference Schiøler T, Lipczak H, Pedersen BL, et al. Incidence of adverse events in hospital patients. The Danish adverse events study. Ugeskr Laeger. 2001;163:5370–8.PubMed Schiøler T, Lipczak H, Pedersen BL, et al. Incidence of adverse events in hospital patients. The Danish adverse events study. Ugeskr Laeger. 2001;163:5370–8.PubMed
2.
go back to reference Bates D, Spell N, Cullen D, et al. The Costs of Adverse Drug Events in Hospitalized Patients. JAMA. 1997;277:307–11.CrossRefPubMed Bates D, Spell N, Cullen D, et al. The Costs of Adverse Drug Events in Hospitalized Patients. JAMA. 1997;277:307–11.CrossRefPubMed
3.
go back to reference Eber M, Laxminarayan R, Perencevich E, Malani A. Clinical and Economic Outcomes Attributable to Health Care-Associated Sepsis and Pneumonia. Arch Intern Med. 2010;170(4):347–53.CrossRefPubMed Eber M, Laxminarayan R, Perencevich E, Malani A. Clinical and Economic Outcomes Attributable to Health Care-Associated Sepsis and Pneumonia. Arch Intern Med. 2010;170(4):347–53.CrossRefPubMed
4.
go back to reference Ehsani JP, Duckett SJ, Jackson T. The incidence and cost of cardiac surgery adverse events in Australian (Victorian) hospitals 2003-2004. Eur J Health Econ. 2007 Dec;8(4):339–46.CrossRefPubMed Ehsani JP, Duckett SJ, Jackson T. The incidence and cost of cardiac surgery adverse events in Australian (Victorian) hospitals 2003-2004. Eur J Health Econ. 2007 Dec;8(4):339–46.CrossRefPubMed
5.
go back to reference Encinosa WE, Hellinger FJ. The impact of medical errors on ninety-day costs and outcomes: an examination of surgical patients. Health Serv Res. 2008 Dec;43(6):2067–85.CrossRefPubMedPubMedCentral Encinosa WE, Hellinger FJ. The impact of medical errors on ninety-day costs and outcomes: an examination of surgical patients. Health Serv Res. 2008 Dec;43(6):2067–85.CrossRefPubMedPubMedCentral
6.
go back to reference Kaushal R, Bates DW, Franz C, Soukup JR, Rothschild JM. Costs of adverse events in intensive care units. Crit Care Med. 2007 Nov;35(11):2479–83.CrossRefPubMed Kaushal R, Bates DW, Franz C, Soukup JR, Rothschild JM. Costs of adverse events in intensive care units. Crit Care Med. 2007 Nov;35(11):2479–83.CrossRefPubMed
7.
go back to reference Kirkland K, Briggs J, Trivette S, et al. The Impact of Surgical-Site Infections in the 1990s: Attributable Mortality, Excess Length of Hospitalization, and Extra Costs. Infect Control Hosp Epidemiol. 1999;20(11):725–30.CrossRefPubMed Kirkland K, Briggs J, Trivette S, et al. The Impact of Surgical-Site Infections in the 1990s: Attributable Mortality, Excess Length of Hospitalization, and Extra Costs. Infect Control Hosp Epidemiol. 1999;20(11):725–30.CrossRefPubMed
8.
go back to reference New PW, Jackson T. The costs and adverse events associated with hospitalization of patients with spinal cord injury in Victoria. Australia Spine (Phila Pa 1976). 2010 Apr 1;35(7):796–802.CrossRef New PW, Jackson T. The costs and adverse events associated with hospitalization of patients with spinal cord injury in Victoria. Australia Spine (Phila Pa 1976). 2010 Apr 1;35(7):796–802.CrossRef
9.
go back to reference Nuckols TK, Paddock SM, Bower AG, Rothschild JM, Fairbanks RJ, Carlson B, et al. Costs of intravenous adverse drug events in academic and nonacademic intensive care units. Med Care. 2008 Jan;46(1):17–24.CrossRefPubMed Nuckols TK, Paddock SM, Bower AG, Rothschild JM, Fairbanks RJ, Carlson B, et al. Costs of intravenous adverse drug events in academic and nonacademic intensive care units. Med Care. 2008 Jan;46(1):17–24.CrossRefPubMed
11.
go back to reference Perencevich E, Sands K, Cosgrove S, et al. Health and Economic Impact of Surgical Site Infections Diagnosed after Hospital Discharge. Emerg Infect Dis. 2003;9(2):196–203.CrossRefPubMedPubMedCentral Perencevich E, Sands K, Cosgrove S, et al. Health and Economic Impact of Surgical Site Infections Diagnosed after Hospital Discharge. Emerg Infect Dis. 2003;9(2):196–203.CrossRefPubMedPubMedCentral
12.
go back to reference Plowman R, Graves N, Griffin MA, Roberts JA, Swan AV, Cookson B, et al. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. J Hosp Infect. 2001 Mar;47(3):198–209.CrossRefPubMed Plowman R, Graves N, Griffin MA, Roberts JA, Swan AV, Cookson B, et al. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. J Hosp Infect. 2001 Mar;47(3):198–209.CrossRefPubMed
13.
go back to reference Zhan C, Miller M. Excess Length of Stay, Charges and Mortality Attributable to Medical Injuries During Hospitalization. JAMA. 2003;290(14):1868–74.CrossRefPubMed Zhan C, Miller M. Excess Length of Stay, Charges and Mortality Attributable to Medical Injuries During Hospitalization. JAMA. 2003;290(14):1868–74.CrossRefPubMed
14.
go back to reference Ehsani J, Jackson T, Duckett S. The incidence and cost of adverse events in Victorian hospitals 2003-04. MJA. 2006;12(11):551–5. Ehsani J, Jackson T, Duckett S. The incidence and cost of adverse events in Victorian hospitals 2003-04. MJA. 2006;12(11):551–5.
15.
go back to reference Hoonhout LH, de Bruijne MC, Wagner C, Zegers M, Waaijman R, Spreeuwenberg P, et al. Direct medical costs of adverse events in Dutch hospitals. BMC Health Serv Res. 2009 Feb 9;9:27.CrossRefPubMedPubMedCentral Hoonhout LH, de Bruijne MC, Wagner C, Zegers M, Waaijman R, Spreeuwenberg P, et al. Direct medical costs of adverse events in Dutch hospitals. BMC Health Serv Res. 2009 Feb 9;9:27.CrossRefPubMedPubMedCentral
16.
17.
go back to reference Brown P, McArthur C, Newby L, et al. Cost of medical injury in New Zealand: a retrospective cohort study. Journal of Health Services Research & Policy. 2002;7(S1):20–34. Brown P, McArthur C, Newby L, et al. Cost of medical injury in New Zealand: a retrospective cohort study. Journal of Health Services Research & Policy. 2002;7(S1):20–34.
18.
go back to reference Griffin FA, Resar RK. IHI Global Trigger Tool for Measuring Adverse Events. 2nd ed. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2009. Griffin FA, Resar RK. IHI Global Trigger Tool for Measuring Adverse Events. 2nd ed. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2009.
19.
go back to reference Vincent C, Burnett S, Carthey J. The measurement and monitoring of safety. London: The Health Foundation; 2013. Vincent C, Burnett S, Carthey J. The measurement and monitoring of safety. London: The Health Foundation; 2013.
21.
go back to reference Stata Corporation: Stata version 13.1, Texas (2013). Stata Corporation: Stata version 13.1, Texas (2013).
22.
go back to reference Efron B, Tibshirani RJ. An introduction to the bootstrap. New York: Chapman & Hall; 1993.CrossRef Efron B, Tibshirani RJ. An introduction to the bootstrap. New York: Chapman & Hall; 1993.CrossRef
23.
go back to reference Barber JA, Thompson SG. Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat Med. 2000;19:3219–36.CrossRefPubMed Barber JA, Thompson SG. Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat Med. 2000;19:3219–36.CrossRefPubMed
24.
go back to reference Nielsen K, Pedersen AHM, Rasmussen K, et al. Work related stressors and adverse events at an emergency department. Am J Emerg Med. 2013;31:504–8.CrossRefPubMed Nielsen K, Pedersen AHM, Rasmussen K, et al. Work related stressors and adverse events at an emergency department. Am J Emerg Med. 2013;31:504–8.CrossRefPubMed
25.
go back to reference Rasmussen K, Pedersen AHM, Nielsen KJ, et al. Work environment influences adverse events in an emergency department. Dan Med J. 2014;61(5):A4812.PubMed Rasmussen K, Pedersen AHM, Nielsen KJ, et al. Work environment influences adverse events in an emergency department. Dan Med J. 2014;61(5):A4812.PubMed
27.
go back to reference Patientombuddet: Annual report 2013, Danish Patientsafety Database part 1. Patientombuddet: København, 2014. Patientombuddet: Annual report 2013, Danish Patientsafety Database part 1. Patientombuddet: København, 2014.
Metadata
Title
Costs associated with adverse events among acute patients
Authors
Jakob Kjellberg
Rasmus Trap Wolf
Marie Kruse
Susanne R. Rasmussen
Jesper Vestergaard
Kent J. Nielsen
Kurt Rasmussen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2605-5

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