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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

Excess length of stay and economic consequences of adverse events in Dutch hospital patients

Authors: Janneke Hoogervorst-Schilp, Maaike Langelaan, Peter Spreeuwenberg, Martine C. de Bruijne, Cordula Wagner

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

To investigate the average and extrapolated excess length of stay and direct costs of adverse events (AEs) and preventable AEs in Dutch hospitals, and to evaluate patient characteristics associated with excess length of stay and costs.

Methods

Data of a large retrospective patient record review study on AEs was used. A stratified sample of 20 Dutch hospitals was included. Excess length of stay and costs attributable to AEs and preventable AEs were calculated and extrapolated to a national estimate. The association between patient characteristics and excess length of stay (and costs thereof) attributable to AEs and preventable AEs was investigated through multilevel linear regression analyses.

Results

A total of 2975 patient records were included in the analysis, of which 325 experienced one or more AEs. Hospital patients experiencing an AE stayed 5.11 (95 % CI 3.91–6.30) more days in hospital and cost €2600 (95 % CI €1968–€3232) more compared to those without an AE. There was no significant difference in days and costs between preventable and non-preventable AEs. Extrapolated to a national level, AEs cost more than €300 million, which was 1.3 % of the national hospital care budget. Patients with hospital-acquired infections had a statistically significant longer length of stay compared to the reference group (patients with AEs on the cardiovascular system).

Conclusions

This study showed that AEs lead to substantial excess length of stay and increased costs. Special attention should be paid to patients with AEs due to an hospital-acquired infection.
Literature
1.
Zegers M, de Bruijne MC, Wagner C, Hoonhout LH, Waaijman R, Smits M, et al. Adverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study. Qual Saf Health Care. 2009;18(4):297–302.CrossRefPubMed
2.
Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. Cmaj. 2004;170(11):1678–86.CrossRefPubMedPubMedCentral
3.
Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. 1991. Qual Saf Health Care. 2004;13(2):145–51. discussion 151–142.CrossRefPubMedPubMedCentral
4.
Davis P, Lay-Yee R, Briant R, Ali W, Scott A, Schug S. Adverse events in New Zealand public hospitals I: occurrence and impact. N Z Med J. 2002;115(1167):U271.PubMed
5.
Soop M, Fryksmark U, Koster M, Haglund B. The incidence of adverse events in Swedish hospitals: a retrospective medical record review study. Int J Qual Health Care. 2009;21(4):285–91.CrossRefPubMedPubMedCentral
6.
7.
Thomas EJ, Studdert DM, Burstin HR, Orav EJ, Zeena T, Williams EJ, et al. Incidence and types of adverse events and negligent care in Utah and Colorado. Med Care. 2000;38(3):261–71.CrossRefPubMed
8.
Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD. The quality in Australian health care study. Med J Aust. 1995;163(9):458–71.PubMed
9.
Ackroyd-Stolarz S, Read Guernsey J, Mackinnon NJ, Kovacs G. The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study. BMJ Qual Saf. 2011;20(7):564–9.CrossRefPubMed
10.
Cihangir S, Borghans I, Hekkert K, Muller H, Westert G, Kool RB. A pilot study on record reviewing with a priori patient selection. BMJ Open. 2013;3:7.CrossRef
11.
Forster AJ, Kyeremanteng K, Hooper J, Shojania KG, van Walraven C. The impact of adverse events in the intensive care unit on hospital mortality and length of stay. BMC Health Serv Res. 2008;8:259.CrossRefPubMedPubMedCentral
12.
Hoonhout LH, de Bruijne MC, Wagner C, Asscheman H, van der Wal G, van Tulder MW. Nature, occurrence and consequences of medication-related adverse events during hospitalization: a retrospective chart review in the Netherlands. Drug Saf. 2010;33(10):853–64.CrossRefPubMed
13.
Ricciardi R, Roberts PL, Read TE, Hall JF, Marcello PW, Schoetz DJ. Which adverse events are associated with mortality and prolonged length of stay following colorectal surgery? J Gastrointest Surg. 2013;17(8):1485–93.CrossRefPubMed
14.
Sari AB, Sheldon TA, Cracknell A, Turnbull A, Dobson Y, Grant C, et al. Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. Qual Saf Health Care. 2007;16(6):434–9.CrossRefPubMedPubMedCentral
15.
Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1997;277(4):301–6.CrossRefPubMed
16.
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;8(4):339–46.CrossRefPubMed
17.
Hellsten EK, Hanbidge MA, Manos AN, Lewis SJ, Massicotte EM, Fehlings MG, et al. An economic evaluation of perioperative adverse events associated with spinal surgery. Spine J. 2013;13(1):44–53.CrossRefPubMed
18.
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;9:27.CrossRefPubMedPubMedCentral
19.
Hug BL, Keohane C, Seger DL, Yoon C, Bates DW. The costs of adverse drug events in community hospitals. Jt Comm J Qual Patient Saf. 2012;38(3):120–6.PubMed
20.
Kaushal R, Bates DW, Franz C, Soukup JR, Rothschild JM. Costs of adverse events in intensive care units. Crit Care Med. 2007;35(11):2479–83.CrossRefPubMed
21.
Kessler ER, Shah M, Gruschkus SK, Raju A. Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from a large health system: opioid-related adverse events and their impact on clinical and economic outcomes. Pharmacotherapy. 2013;33(4):383–91.CrossRefPubMed
22.
Kim MH, Lin J, Hussein M, Battleman D. Incidence and economic burden of suspected adverse events and adverse event monitoring during AF therapy. Curr Med Res Opin. 2009;25(12):3037–47.CrossRefPubMed
23.
Oderda GM, Evans RS, Lloyd J, Lipman A, Chen C, Ashburn M, et al. Cost of opioid-related adverse drug events in surgical patients. J Pain Symptom Manage. 2003;25(3):276–83.CrossRefPubMed
24.
Rottenkolber D, Hasford J, Stausberg J. Costs of adverse drug events in German hospitals--a microcosting study. Value Health. 2012;15(6):868–75.CrossRefPubMed
25.
Schneider PJ, Gift MG, Lee YP, Rothermich EA, Sill BE. Cost of medication-related problems at a university hospital. Am J Health Syst Pharm. 1995;52(21):2415–8.PubMed
26.
Naessens JM, Campbell CR, Shah N, Berg B, Lefante JJ, Williams AR, et al. Effect of illness severity and comorbidity on patient safety and adverse events. Am J Med Qual. 2012;27(1):48–57.CrossRefPubMed
27.
Baines R, Langelaan M, de Bruijne M, Spreeuwenberg P, Wagner C. How effective are patient safety initiatives? A retrospective patient record review study of changes to patient safety over time. BMJ Qual Saf. 2015;24(9):561–71.CrossRefPubMedPubMedCentral
28.
29.
Hakkaart-Roijen L, Tan SS, Bouwmans CAM. Handleiding voor kostenonderzoek: Methoden en standaard kostprijzen voor economische evaluatie in de gezondheidszorg (in Dutch): CVZ. 2010.
30.
Langelaan M, De Bruijne MC, Baines RJ, Broekens MA, Hammink K, Schilp J, et al. Monitor Zorggerelateerde Schade 2011/2012: dossieronderzoek in Nederlandse ziekenhuizen (in Dutch). Amsterdam/Utrecht: EMGO+ Instituut/VUmc, NIVEL. 2013.
31.
Twisk JW. Applied multilevel analysis: a practical guide: Cambridge University Press. 2006.CrossRef
32.
Forster AJ, Taljaard M, Oake N, Wilson K, Roth V, van Walraven C. The effect of hospital-acquired infection with Clostridium difficile on length of stay in hospital. CMAJ. 2012;184(1):37–42.CrossRefPubMedPubMedCentral
33.
Allegranzi B, Pittet D. Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect. 2009;73(4):305–15.CrossRefPubMed
Metadata
Title
Excess length of stay and economic consequences of adverse events in Dutch hospital patients
Authors
Janneke Hoogervorst-Schilp
Maaike Langelaan
Peter Spreeuwenberg
Martine C. de Bruijne
Cordula Wagner
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1205-5

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