The DOI matches its Crossref record; 16 of the 18 references it cites were found in a registry or an index.
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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]
Citations
Cites
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
Cited by
Sorted by citations
Items 101–169 of 169
Parallel Duplicate Detection in Adverse Drug Reaction Databases with Spark
Wang, C., & Karimi, S. (2016) · Movebank · doi:10.5441/002/edbt.2016.52 · Cited by 7
Interventions for reducing medication errors in children in hospital
Soe, A., Apampa, B., Fernando, B., Maaskant, J. M., Neubert, A. C., Thayyil, S., Vermeulen, H., & Ghaleb, M. A. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006208.pub2 · Cited by 7
Which trial do we need? Shorter antifungal treatment for candidemia – challenging the 14-day dogma
Bekaan, N., Cornely, O. A., Friede, T., Prattes, J., Sprute, R., Hellmich, M., Koehler, P. A., Salmanton‐García, J., Stemler, J., & Reinhold, I. (2024) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2024.09.004 · Cited by 6
Improving Health of At-Risk Rural Patients project: A collaborative care model
Matzke, G. R., Czar, M. J., Lee, W. T., Moczygemba, L. R., & Harlow, L. D. (2016) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp160331 · Cited by 6
Nurses as adverse drug reaction reporting advocates
Schjøtt, J. D., Pettersen, T. R., Andreassen, L. M., & Bjånes, T. K. (2022) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvac113 · Cited by 6
Conocimiento de las enfermeras de las dosis de medicamentos en urgencias de pediatría
Guerrero-Márquez, G., Martínez-Serrano, A., Navarro, C. M., López-Mirón, J. A., & Larrayad, M. E. (2016) · Enfermería Clínica · doi:10.1016/j.enfcli.2016.04.009 · Cited by 6
Cost-effectiveness of check of medication appropriateness: methodological approach
D’hulster, E., Quintens, C., Bisschops, R., Willems, R., Peetermans, W. E., Verbakel, J. Y. J., & Luyten, J. (2022) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-021-01356-6 · Cited by 6
Cosgrave, N., Saleh, S., Ong, W. S., Frydenlund, J., Williams, D. J., & Cahir, C. (2024) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-024-03774-7 · Cited by 5
Race and Ethnicity Have a Mixed Effect on the Treatment of Tibial Plateau Fractures
Driesman, A. S., Mahure, S. A., Paoli, A. R., Pean, C. A., Konda, S. R., & Egol, K. A. (2017) · Journal of Orthopaedic Trauma · doi:10.1097/bot.0000000000000917 · Cited by 5
Hasham, S., Moye, P. M., & Thurston, M. M. (2022) · American Journal of Health-System Pharmacy · doi:10.1093/ajhp/zxac342 · Cited by 4
Austin, J. M., Bane, A., Gooder, V., Saltsman, C. L., Wilson, M. L., Stewart, K. B., Derk, J. M., Danforth, M., & Michalek, C. (2022) · Journal of Patient Safety · doi:10.1097/pts.0000000000001052 · Cited by 4
Natanaelsson, J., Hakkarainen, K. M., Hägg, S., Sundell, K. A., Petzold, M., Rehnberg, C., Jönsson, A. K., & Gyllensten, H. (2016) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2016.11.008 · Cited by 4
Application of zero trust model in preventing medical errors
Sood, N., Parlapalli, R., Sharma, P., & Kashyap, R. (2024) · Frontiers in Health Services · doi:10.3389/frhs.2024.1453804 · Cited by 3
“Adverse drug events have been shown to increase both the cost and the length of stay in community hospitals (8).”
BackgroundPharmacovigilance of Biosimilars: Global Experience and Perspective
Felix, T., Patel, B., Bradbury, B. D., & Grampp, G. E. (2018) · AAPS advances in the pharmaceutical sciences series · doi:10.1007/978-3-319-99680-6_23 · Cited by 3
Utilizing Pharmacogenomics to Reduce Adverse Drug Events
Amin, N. S. (2020) · American Journal of Biomedical Science & Research · doi:10.34297/ajbsr.2020.11.001638 · Cited by 3
Position Statement: Medical Toxicologist Participation in Medication Management and Safety Systems
American College of Medical Toxicology (2015) · Journal of Medical Toxicology · doi:10.1007/s13181-013-0361-4 · Cited by 3
Identifying Potential High-Risk Medication Errors Using Telepharmacy and a Web-Based Survey Tool
Huq, N., Padilla‐Tolentino, E., & McGinnis, B. (2021) · INNOVATIONS in pharmacy · doi:10.24926/iip.v12i1.3377 · Cited by 3
Differences between social media and regulatory databases in adverse drug reaction discovery
Wang, C., & Karimi, S. (2014) · doi:10.1145/2632188.2632201 · Cited by 3
de Terline, D. M., Hindlet, P., Carmona, B., Fratta, A., Baud-Camus, F., Fernandez, C., & Antignac, M. (2018) · Le Pharmacien Hospitalier et Clinicien · doi:10.1016/j.phclin.2018.03.005 · Cited by 3
Drug-related mortality among inpatients admitted in Internal Medicine
Pardo-Cabello, A. J., Manzano‐Gamero, V., Del-Pozo, E., Gómez-Jiménez, F. J., Castillo, J. D. D. L.-D., & Puche-Cañas, E. (2018) · Anales del Sistema Sanitario de Navarra · doi:10.23938/assn.0381 · Cited by 3
Umoh, E. O., & Opue, B. O. (2021) · Cognizance Journal of Multidisciplinary Studies · doi:10.47760/cognizance.2021.v01i06.003 · Cited by 3
Thomas, L., Chung, J. H., Lu, S., & Essilfie, A. (2024) · Journal of Orthopaedics · doi:10.1016/j.jor.2024.06.006 · Cited by 2
The impact of PIPs on mortality and readmissions in older adults: a retrospective cohort study
Pardo-Cabello, A. J., Manzano‐Gamero, V., & Luna, J. D. D. (2021) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-021-03217-7 · Cited by 2
Newe, A. (2016) · PeerJ · doi:10.7717/peerj.1851 · Cited by 2
Provider and Patient Perceptions of an External Medication History Function
Wolver, S. E., Stultz, J. S., Aggarwal, A., Thacker, L. R., & Banas, C. A. (2015) · Journal of Patient Safety · doi:10.1097/pts.0000000000000197 · Cited by 2
Unerwünschte Arzneimittelwirkungen – Definitionen, Einteilung, Risikofaktoren und Pharmakovigilance
Krähenbühl, S. (2015) · Therapeutische Umschau · doi:10.1024/0040-5930/a000735 · Cited by 2
Exploring the Potential of Direct-To-Consumer Genomic Test Data for Predicting Adverse Drug Events
Zhang, P. M. (2018) · Europe PMC (PubMed Central) · doi:10.26300/z6n9-xd36 · Cited by 2
Inglis, J. M., Medlin, S., Bryant, K., Mangoni, A. A., & Phillips, C. J. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.105083 · Cited by 2
Improving Patient Safety: Reducing Medication Errors in the Microsystem
Dent, E. M. (2015) · USF Scholarship Repository (University of San Francisco) · Cited by 2
Custos hospitalares associados aos eventos adversos medicamentosos: Revisão sistemática
da Silva, S. C., Rodrigues, R. C., & Rodrigues, M. R. K. (2021) · Research Society and Development · doi:10.33448/rsd-v10i4.14030 · Cited by 2
Medved, C. F. (2016) · Scholarship at UWindsor (University of Windsor) · Cited by 2
Coloma, P. M., Schuemie, M. J., Trifirò, G., Furlong, L. I., van Mulligen, E. M., Bauer‐Mehren, A., Avillach, P., Kors, J. A., Sanz, F., Mestres, J., et al. (2013) · PLoS ONE · doi:10.1371/annotation/8824e161-bf8f-4f78-81e0-a62a1540276d · Cited by 2
Asadi, S., Moradi, O., Amini, H., Goodarzian, M., Babaei, M., & Goodarzian, M. (2024) · Journal of Comprehensive Pediatrics · doi:10.5812/jcp-144355 · Cited by 1
Kolesnik, T. I., Адыгамовна, Г. Л., & Павликова, Е. П. (2025) · Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice · doi:10.37489/2588-0519-2025-3-97-105 · Cited by 1
Economic Impact Of Drug-Related Morbidity In Sweden
Gyllensten, H. (2015) · Value in Health · doi:10.1016/j.jval.2015.09.1657 · Cited by 1
López-Romero, L. A., Rivera, D. I. C., Badillo, R. E. D., Barón, J. V. A., Méndez, I. Y. R., Castillo, D. R., & de Rey, G. I. P. (2019) · Salud UIS · doi:10.18273/revsal.v51n4-2019002 · Cited by 1
Rezazadeh, A., Hajimiri, S. H., Kebriaeezadeh, A., Gholami, K., Hashemian, F., Khoshnevisan, A., & Mohebbi, N. (2021) · Journal of Pharmaceutical Health Services Research · doi:10.1093/jphsr/rmab026 · Cited by 1
Reassessing the impact of health IT: Hidden costs and consequences of vendor heterogeneity
Lin, J., & Olson, M. K. (2024) · Journal of Economics & Management Strategy · doi:10.1111/jems.12600 · Cited by 1
Best Practice Medication Reconciliation in the Outpatient Setting
Hession, M. J. (2024) · Scholarworks (University of Massachusetts Amherst) · doi:10.7275/12078005 · Cited by 1
Patients' claims regarding drug allergies
Dmitrović, R., & Živanović, S. (2020) · Hospital Pharmacology - International Multidisciplinary Journal · doi:10.5937/hpimj2001875d · Cited by 1
(2019) · Archivos Argentinos de Pediatria · doi:10.5546/aap.2019.e106 · Cited by 1
Incidence of Adverse Drug Reactions in Two Tertiary Hospitals: A Prospective Observational StudyPreprint
Khalili, M., Sharifi, H. P., Mesgarpour, B., Dabaghzadeh, F., & Haghdoost, A. A. (2021) · Research Square · doi:10.21203/rs.3.rs-818170/v1 · Cited by 1
Custódio, P. L. C. (2023) · doi:10.14393/ufu.di.2023.149 · Cited by 1
Praktische Aspekte der Arzneimittelsicherheit
Hug, B. L. (2013) · Praxis · doi:10.1024/1661-8157/a001287
Keepanasseril, A., McKibbon, A., Flynn, T., Iorio, A., & McMaster eBusiness Research Centre (MeRC) (2012) · doi:10.71548/1375
Ameye, T., Perron, J., Adehoss, A., Guillocheau, É., & Schmit, B. (2015) · Pharmactuel
Khandelwal, S. K., Bairy, K., Vidyasagar, V., Kamath, A., Gonsalves, J., & Chogtu, B. (2016)
Risk factors to early predict adverse drug events related to hospitalizations
Mastroianni, P. D. C., & Varallo, F. R. (2015) · Revista Vitae · doi:10.17533/udea.vitae.v22n3a01
Exploring care for older people : district nurses’ experiences and clinical practice
Lagerin, A. (2016) · Figshare
Sulaiman, M. G., MOHAMMAD, F. K., & Al-Hassani, A. N. (2018) · Duhok Medical Journal · doi:10.31386/dmj.2017.11.3
Stollings, J. L. (2018) · Springer eBooks · doi:10.1007/978-3-319-94337-4_22
2012년 개정판 Beers Criteria를 통한 노인 부적절 약물 처방 현황에 관한 연구
장일영 (2013) · Annals of Geriatric Medicine and Research
Peloza, J. H., Millgram, M. A., Jacobian, E., Kolsky, D. E., Guyer, R. D., Huec, J. L., & Ashkenazi, E. (2021) · PharmacoEconomics - Open · doi:10.1007/s41669-020-00256-1
Webster, C. S. (2013) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.718086680.793483956
Iwanicki, J. L. (2017) · Springer eBooks · doi:10.1007/978-3-319-17900-1_74
Iwanicki, J. L. (2016) · Springer eBooks · doi:10.1007/978-3-319-20790-2_74-1
Automatic detection of adverse drug events in the geriatric care: study protocol (Preprint)Preprint
Gaspar, F., Lutters, M., Beeler, P. E., Lang, P. O., Burnand, B., Rinaldi, F., Lovis, C., Casjka, C., & Pogam, M. L. (2022) · doi:10.2196/preprints.40456
ANÁLISE DE PRESCRIÇÕES MÉDICAS E A SEGURANÇA DO PACIENTE EM UM HOSPITAL PEDIÁTRICO
da Silva, J. B., do Nascimento, T. A., Pimentel, S. M., de Macedo, R. C., Santos, L. F., & de Oliveira, J. M. B. B. (2023) · DESAFIOS Revista Interdisciplinar da Universidade Federal do Tocantins · doi:10.20873/uftv1n123-12021
Stollings, J. L. (2025) · Springer eBooks · doi:10.1007/978-3-031-83786-9_20
Masiliūnienė, G., Gumbrevičius, G., Stankevıčıus, E., & Kaduševičius, E. (2025) · Healthcare · doi:10.3390/healthcare13131592
Hertig, J. B., Louden, L., Shay, B., Soto, A., Doan, T., & Gross, Z. (2025) · Pharmacy · doi:10.3390/pharmacy13050121
Impact of Pharmacy Technician-Led Medication Reconciliation on Patient Safety in Hospital Settings
Alruwaili AfAf Bani, H., Alhazmi, F. M. O., Alenezi, M., Alanazi, N. D. O., Alhazmi, T. M. R., Al-Hazmi, M., Alanazi, R. S., Alanazi Samiyah Sulaiman, S., Al-Enezi, H., Alanazi, R. O. M., et al. (2024) · International Journal of Computational and Experimental Science and Engineering · doi:10.22399/ijcesen.4026
Estimating cost savings from reducing antibiotic overprescription in european general practices
Floriano, F. R., Vallejo‐Torres, L., Elistratova, M., López‐Valcárcel, B. G., García-Sangenís, A., Lykkegaard, J., Hansen, M. P., Bjerrum, L., Chalkidou, A., Jensen, J. N., et al. (2026) · The European Journal of Health Economics · doi:10.1007/s10198-026-01899-3 · Cited by 1
Wiercioch, W. (2014) · MacSphere (McMaster University) · doi:10.71548/11869
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review