Marginal costs of hospital-acquired conditions: information for priority-setting for patient safety programmes and research (original) (raw)

The incidence and cost of adverse events in Victorian hospitals 2003-04

The Medical journal of Australia, 2006

To determine the incidence of adverse events in patients admitted in the year 2003-04 to selected Victorian hospitals; to identify the main hospital-acquired diagnoses; and to estimate the cost of these complications to the Victorian and Australian health system. The patient-level costing dataset for major Victorian public hospitals, 1 July 2003-30 June 2004, was analysed for adverse events by identifying C-prefixed diagnosis codes denoting complications, preventable or otherwise, arising during the course of hospital treatment. The in-hospital cost of adverse events was estimated using linear regression modelling, adjusting for age and comorbidity. Cost of each patient admission ("admitted episode"), length of stay and mortality. During the designated timeframe, 979,834 admitted episodes were in the sample, of which 67,435 (6.88%) had at least one adverse event. Patients with adverse events stayed about 10 days longer and had over seven times the risk of in-hospital death...

The incidence and cost of adverse events in Victorian hospitals 2003-2004

Medical Journal of Australia, 2006

To determine the incidence of adverse events in patients admitted in the year 2003-04 to selected Victorian hospitals; to identify the main hospital-acquired diagnoses; and to estimate the cost of these complications to the Victorian and Australian health system. Design: The patient-level costing dataset for major Victorian public hospitals, 1 July 2003 -30 June 2004, was analysed for adverse events by identifying C-prefixed diagnosis codes denoting complications, preventable or otherwise, arising during the course of hospital treatment. The in-hospital cost of adverse events was estimated using linear regression modelling, adjusting for age and comorbidity. Main outcome measures: Cost of each patient admission ("admitted episode"), length of stay and mortality. Results: During the designated timeframe, 979 834 admitted episodes were in the sample, of which 67 435 (6.88%) had at least one adverse event. Patients with adverse events stayed about 10 days longer and had over seven times the risk of in-hospital death than those without complications. After adjusting for age and comorbidity, the presence of an adverse event adds 6826tothecostofeachadmittedepisode.Thetotalcostofadverseeventsinthisdatasetin2003−04was6826 to the cost of each admitted episode. The total cost of adverse events in this dataset in 2003-04 was 6826tothecostofeachadmittedepisode.Thetotalcostofadverseeventsinthisdatasetin2003−04was460.311 million, representing 15.7% of the total expenditure on direct hospital costs, or an additional 18.6% of the total inpatient hospital budget. Conclusion: Adverse events are associated with significant costs. Administrative datasets are a cost-effective source of information that can be used for a range of clinical MJA 2006; 184: 551-555 governance activities to prevent adverse events.

Costs associated with adverse events among acute patients

BMC Health Services Research

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.

Estimating the costs of potentially preventable hospital acquired complications

Health care financing review, 2009

California and Maryland hospital data are used to estimate the incremental cost associated with 64 categories of hospital acquired complications. The reason for admission, severity of illness at admission and the presence of hospital acquired complications are used in a linear regression model to predict incremental per patient cost yielding an adjusted R2 of 0.58 for Maryland data and 0.60 for California data. The estimated incremental cost due to each of the 64 categories of complications was consistent across both databases and accounted for an increase in total short term acute inpatient hospital cost of 9.39 percent in the California data and 9.63 percent in the Maryland data.

Measuring the economic impact of hospital-acquired complications on an acute health service

Australian Health Review, 2020

ObjectiveThis study determined the economic impact of 16 ‘high-priority’ hospital-acquired complications (HACs), as defined by the Australian Commission on Safety and Quality in Health Care, from the perspective of an individual Australian health service. MethodsA retrospective cohort study was performed using a deidentified patient dataset containing 93056 in-patient separations in Northern Health (Victoria, Australia) from 1 July 2016 to 30 June 2017. Two log-linked generalised linear regression models were used to obtain additional costs and additional length of stay (LOS) for 16 different HACs, with the main outcome measures being the additional cost and LOS for all 16 HACs. ResultsIn all, 1700 separations involving HACs (1.83%) were identified. The most common HAC was health care-associated infections. Most HACs were associated with a statistically significant risk of increased cost (15/16 HACs) and LOS (11/16 HACs). HACs involving falls resulting in fracture or other intracran...

Variation in the rates of adverse events between hospitals and hospital departments

International Journal for Quality in Health Care, 2011

Objective. The objective of this study was to analyze the variation in the rates of adverse events (AEs), and preventable AEs, between hospitals and hospital departments in order to investigate the room for improvement in reducing AEs at both levels. In addition, we explored the extent to which patient, department and hospital characteristics explain differences in the rates of AEs.

Direct medical costs of adverse events in Dutch hospitals

BMC Health Services Research, 2009

Background: Up to now, costs attributable to adverse events (AEs) and preventable AEs in the Netherlands were unknown. We assessed the total direct medical costs associated with AEs and preventable AEs in Dutch hospitals to gain insight in opportunities for cost savings.