The Costs of Adverse Drug Events in Hospitalized Patients

Bates, David W.; Spell, Nathan O.; Cullen, David J.; Burdick, Elisabeth; Iaird, Nan; Petersen, Laura A.; Small, Stephen D.; Sweitzer, Bobbie Jean; Leape, Lucian L.

doi:10.1097/00132586-199802000-00016

Cited by 912 publications

(310 citation statements)

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“…2 Other studies have produced similarly striking results. [3][4][5] Since 1994 there have been a number of efforts to study adverse events in medicine and establish strategies to reduce them, including the founding of the National Patient Safety Foundation as a branch of the American Medical Association, the revision of the policy on medical error reporting of the Joint Commission on Accreditation of Healthcare Organizations, and the establishment of a patient safety improvement initiative at the Veterans Administration. 6,7 Where does EM fit into this?…”

Section: Medical Error In the 1990smentioning

confidence: 99%

“…22 While development of computer order entry is expensive, prevention of a single adverse drug event represents an estimated savings of $2,595, and possibly as much as $4,685, in hospital charges. 5 Hennepin County Medical Center has reported the successful implementation of a computer order entry system (EmSTAT, WebMentors, Plainfield, IL), combined with a patient tracking system, in the ED. 121 Color-coded timers on a tracking board indicate when an order is in need of cosigning, outstanding, in process, or completed.…”

Section: Teachingmentioning

confidence: 99%

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Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Schenkel

2000

Academic Emergency Medicine

133

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Abstract. An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice.

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Section: Medical Error In the 1990smentioning

confidence: 99%

Section: Teachingmentioning

confidence: 99%

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Schenkel

2000

Academic Emergency Medicine

133

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“…If a physician prescribes a medicine F to a patient, not knowing that the patient is already taking medicines A-E, or even he knows he does not notice for any reasons that the substance X1 of the medicine F may be in the interaction with the substance X32 of the medicine E, an adverse drug event (ADE) may occur with serious unfavourable health consequences for the patient. ADEs occur in the wake of consumption of drugs which should not have been prescribed on account of an interaction(s) with another medicine (BATES et al, 1997;AAHERN et al, 2006;BABEĽA et al, 2008). ADEs occurring during hospitalization are common.…”

Section: Preventable Bed-days Length Of Hospitalizationsmentioning

confidence: 99%

Efficiency Evaluation of Hospitals in the Environment of the Slovak Republic

Sendek¹

2014

Acta Univ. Agric. Silvic. Mendelianae Brun.

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The paper applies the Data Envelopment Analysis as a deterministic non-parametric method based on the linear programming, to measure the effi ciency of Slovak hospitals based on input and output performance. Managing physician or hospital practice patterns is an important tool to reduce health care costs. State-run hospitals, as decision-making units working in an operating healthcare system of the country, might have some excess resources in the process of providing care. It is also e-health tools which might contribute to the cost containment in them, enhancing fi nally the quality of patient care in the overall assessment.

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“…En el análisis general, se encontró que el mayor número de eventos prevenibles se asoció a dosis, ruta o frecuencia de administración de los medicamentos no apropiados para la edad, el peso o el estado de la enfermedad (51,4 %), y a interacciones medicamentosas (45 %), los cuales están descritos dentro de los problemas relacionados con medicamentos (24 (3,25,26).…”

Section: Análisis De Costosunclassified

Costos directos e impacto sobre la morbimortalidad hospitalaria de eventos adversos prevenibles a medicamentos en una institución de tercer nivel de Bogotá

et al. 2011

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Introducción. La implementación de actividades de farmacovigilancia permite supervisar y evaluar aspectos relacionados con la atención médica. Es necesario que la información recolectada permita identificar oportunidades para mejorar la calidad de la atención en salud. Se propone un análisis de los eventos adversos a medicamentos desde la óptica preventiva y económica, estableciendo su impacto local. Objetivo. Determinar el porcentaje de eventos adversos prevenibles a medicamentos, reportados en una institución de tercer nivel, para establecer su impacto sobre la morbimortalidad y el económico desde la óptica del pagador y mostrando la relevancia de usar un método que permita identificarlos y evitar o disminuir su presentación. Materiales y métodos. A partir de los reportes generados durante actividades de farmacovigilancia en el año 2007 en un hospital de tercer nivel de Bogotá, se revisaron las historias clínicas de los pacientes involucrados y se evaluó la relación de causalidad, la gravedad y el carácter prevenible de los eventos adversos a medicamentos. Se calcularon los costos directos generados, agrupándolos en pruebas diagnósticas, tiempo de estancia adicional, procedimientos y medicamentos adicionales. Resultados. Se revisaron 448 reportes de eventos adversos a medicamentos en 283 pacientes y se encontró que 24,8 % de los eventos reportados eran prevenibles, con mortalidad de 1,1 % y costos totales asociados con su atención entre $ 33´620.346 (US$ 16.687) y $ 37´754.856 (US$ 18.739). Los factores más frecuentemente asociados con la prevención fueron las interacciones farmacológicas y las dosis o frecuencias inadecuadas de administración. Conclusiones. Es importante tomar medidas tendientes a disminuir la presentación de eventos adversos prevenibles a medicamentos, ya que repercuten negativamente tanto sobre la salud de los pacientes, como en el consumo de recursos.Palabras clave: toxicidad de medicamentos, hospitales, costos y análisis de costo, estudios de evaluación, Colombia. Direct costs and hospital morbimortality impact from preventable adverse drug eventsIntroduction. Implementing pharmacovigilance activities consists of monitoring and assessment of activities related to medical attention. However, additional data are necessary to identify conditions where care quality can be improved. Therefore, a focus on adverse drug events analysis from a prevention and economic perspective is needed, with emphasis on its local impact. Objective. Preventable adverse drug events were summarized to establishing their impact on morbidity and mortality, as well as to estimate the ensuing economic burden. Materials and methods. The data were gathered from a level 3 hospital (high complexity), located in Bogotá, Colombia, where specific pharmacovigilance activities were recorded in 2007. Patient charts were reviewed to characterize adverse drug events according to their causality, severity and preventability. Direct costs were estimated by grouping diagnostic tests, length of hospitalization, procedures and additio...

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The Costs of Adverse Drug Events in Hospitalized Patients

Cited by 912 publications

References 0 publications

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Promoting Patient Safety and Preventing Medical Error in Emergency Departments

Efficiency Evaluation of Hospitals in the Environment of the Slovak Republic

Costos directos e impacto sobre la morbimortalidad hospitalaria de eventos adversos prevenibles a medicamentos en una institución de tercer nivel de Bogotá

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