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The Costs of Adverse Drug Events in Community Hospitals
Abstract
Background Adverse drug events (ADEs) occur often in hospitals, causing high morbidity and a longer length of stay (LOS), and are costly. However, most studies on the impact of ADEs have been conducted in tertiary referral centers, which are systematically different than community hospitals, where the bulk of care is delivered, and most available data about ADE costs in any setting are dated. Costs in community settings are generally lower than in academic hospitals, and the costs of ADEs might be as well. To assess the additional costs and LOS associated with patients with ADEs, a multicenter retrospective cohort study was conducted in six community hospitals with 100 to 300 beds in Massachusetts during a 20-month observation period (January 2005-August 2006).Methods A random sample of 2,100 patients (350 patients per study site) was drawn from a pool of 109,641 patients treated within the 20-month observation period. Unadjusted and adjusted cost of ADEs as well as LOS were calculated.Results ADEs were associated with an increased adjusted cost of $3,420 and an adjusted increase in length of stay (LOS) of 3.15 days. For preventable ADEs, the respective figures were +$3,511 and +3.37 days. The severity of the ADE was also associated with higher costs--the costs were +$2,852 for significant ADEs (LOS +2.77 days), +$3,650 for serious ADEs (LOS +3.47 days), and +$8,116 for life-threatening ADEs (LOS +5.54 days, all p < .001).Conclusions ADEs in community hospitals cost more than $3,000 dollars on average and an average increase of LOS of 3.1 days--increments that were similar to previous estimates from academic institutions. The LOS increase was actually greater. A number of approaches, including computerized provider order entry and bar coding, have the potential to improve medication safety.
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“Adverse drug events have been shown to increase both the cost and the length of stay in community hospitals (8).”
From Application of zero trust model in preventing medical errors (2024) · cites this paper as [8]
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Institute of Medicine (2000) · National Academies Press eBooks · doi:10.17226/9728 · Cited by 14,390
Wall, A. (2000) · British Journal of Healthcare Management · doi:10.12968/bjhc.2000.6.9.19311 · Cited by 5,912
The Nature of Adverse Events in Hospitalized Patients
Leape, L. L., Brennan, T. A., Laird, N. M., Lawthers, A. G., Localio, A. R., Barnes, B. A., Hebert, L. E., Newhouse, J. P., Weiler, P. C., & Hiatt, H. H. (1991) · New England Journal of Medicine · doi:10.1056/nejm199102073240605 · Cited by 3,766
Incidence of Adverse Drug Events and Potential Adverse Drug Events: Implications for Prevention
Bates, D. W. (1995) · JAMA · doi:10.1001/jama.1995.03530010043033 · Cited by 2,127
Bates, D. W. (1998) · JAMA · doi:10.1001/jama.280.15.1311 · Cited by 2,107
Classen, D. C. (1997) · JAMA · doi:10.1001/jama.277.4.301 · Cited by 1,897
Bates, D. W. (1997) · JAMA · doi:10.1001/jama.277.4.307 · Cited by 1,678
The Costs of Adverse Drug Events in Hospitalized Patients
Bates, D. W. (1997) · JAMA · doi:10.1001/jama.1997.03540280045032 · Cited by 1,072
Relationship between medication errors and adverse drug events
Bates, D. W., Boyle, D. L., Vliet, M. B. V., Schneider, J., & Leape, L. (1995) · Journal of General Internal Medicine · doi:10.1007/bf02600255 · Cited by 981 · cited 2×
“DEFINITIONS A medication error is defined as an error anywhere in the process of ordering, delivering, or administering a drug.(16) An ADE is defined as a medication error with a drug actually harming the patient.”
BackgroundDrug-Related Problems in Hospitals
hl-Melcher, A. K. H., Schlienger, R. G., Lampert, M. L., Haschke, M., Drewe, J., & hl, S. K. H. (2007) · Drug Safety · doi:10.2165/00002018-200730050-00003 · Cited by 542
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Blumenthal, K. G., Peter, J. G., Trubiano, J. A., & Phillips, E. J. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32218-9 · Cited by 614
Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013) · Drug Safety · doi:10.1007/s40264-013-0090-2 · Cited by 516
Cadec: A corpus of adverse drug event annotations
Karimi, S., Metke‐Jimenez, A., Kemp, M., & Wang, C. (2015) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2015.03.010 · Cited by 281
Prgomet, M., Li, L., Niazkhani, Z., Georgiou, A., & Westbrook, J. I. (2016) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocw145 · Cited by 243
Mangin, D. A., Bahat, G., Golomb, B. A., Mallery, L. H., Moorhouse, P. A., Onder, G., Petrović, M., & Garfinkel, D. (2018) · Drugs & Aging · doi:10.1007/s40266-018-0554-2 · Cited by 237
Metadata
- Authors
- Hug, B. L., Keohane, C., Seger, D. L., Yoon, C., & Bates, D. W.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Bates, David W.
- Venue
- The Joint Commission Journal on Quality and Patient Safety
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 38
- Issue
- 3
- Pages
- 120-126
- ISSN
- 1553-7250 (ISSN-L)
- OpenAlex
- W315942296
- Cited by
- 169
- References
- 18
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 12 · 2023: 7 · 2022: 10 · 2021: 10 · 2020: 8 · 2019: 10 · 2018: 14 · 2017: 20 · 2016: 24 · 2015: 18 · 2014: 11 · 2013: 18 · 2012: 1
- FWCI
- 26.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Joint Commission Journal on Quality and Patient Safety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Brigham and Women’s Hospital (6029138)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- adverse drug reactions, community hospitals, hospital costs, length of hospital stay, preventable adverse drug events, drug safety, computerized physician order entry, barcoding
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Hospital Bed Capacity, 100 to 299, Hospitals, Community, Humans, Insurance, Health, Length of Stay, Male, Medication Errors, Middle Aged, Retrospective Studies, Hospital Costs, Hospital Charges, Racial Groups, Young Adult, Drug-Related Side Effects and Adverse Reactions
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