The Costs of Adverse Drug Events in Community Hospitals
The Costs of Adverse Drug Events in Community Hospitals
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DOI：
10.1016/s1553-7250(12)38016-1
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发表时间：
2012-03-01
影响因子：
2.3
通讯作者：
Bates, David W.
中科院分区：
文献类型：
--
作者：
Hug, Balthasar L.;Keohane, Carol;Bates, David W.
背景：药物不良事件（ADEs）经常发生在医院，导致高发病率和较长的住院时间（LOS），并且费用昂贵。然而，大多数关于ADE影响的研究都是在三级转诊中心进行的，这些转诊中心与社区医院有系统的不同，社区医院提供了大量的护理，而且大多数关于任何环境下ADE成本的可用数据都是过时的。社区环境的费用通常低于学术医院，ADEs的费用也可能如此。为了评估与ade患者相关的额外费用和LOS，在马萨诸塞州6家拥有100至300张床位的社区医院进行了一项多中心回顾性队列研究，为期20个月的观察期（2005年1月至2006年8月）。方法：在20个月的观察期内，从109641例患者中随机抽取2100例患者（每个研究点350例）。计算未调整和调整后的ade成本以及LOS。结果：不良事件与调整费用增加3,420美元和调整住院时间（LOS）增加3.15天相关。对于可预防的ade，数字分别为+ 3,511美元和+3.37天。ADE的严重程度也与较高的费用相关——严重ADE的费用为+ 2,852美元（LOS +2.77天），严重ADE的费用为+ 3,650美元（LOS +3.47天），危及生命的ADE的费用为+ 8,116美元（LOS +5.54天），均为p
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