The Burden of Preventable Adverse Drug Events on Hospital Stay and Healthcare Costs in Japanese Pediatric Inpatients: The JADE Study.
The Burden of Preventable Adverse Drug Events on Hospital Stay and Healthcare Costs in Japanese Pediatric Inpatients: The JADE Study.
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DOI：
10.1177/1179556521995833
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Morimoto T
中科院分区：
文献类型：
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作者：
Iwasaki H;Sakuma M;Ida H;Morimoto T
药物不良事件(ADE)是医疗系统的负担。如果能预防或改善用药差错，则可以减少可预防的ADE，即由于用药差错而引起的ADE。我们调查了可预防的不良反应对住院时间(LOS)和费用的负担，并估计了日本儿科住院患者中可预防的不良反应的国家负担。我们分析了日本不良药物事件(JADE)研究对儿科患者的数据，并估计了可预防的ADE和相关的延长的LOS的发生率。使用国家统计数据库计算了可预防ADE延长损失的成本，并计算了可预防ADE对国家成本超额的影响。我们纳入了907名患者，7377个病例日。其中，31例(3.4%)患者在住院期间发生了可预防的不良反应。在调整了性别、年龄、病房、住院医生、住院期间的手术、癌症和出生时的严重畸形后，可预防的ADE显著增加了14.1ADE的 天数。延长14.1% 天数造成的个人成本估计为8,258美元。我们计算了日本每年可预防的ADE的额外费用为329 676 760。考虑到可预防的不良反应发生率和住院时间的敏感性分析表明，日本每年可预防的不良反应的预期额外费用范围在141 468 968到588 450 708之间。可预防的不良反应导致儿科住院患者住院时间延长和相当大的额外医疗费用。我们的结果将鼓励进一步努力预防和改善可预防的不良反应。
Adverse drug events (ADEs) are a burden to the healthcare system. Preventable ADEs, which was ADEs due to medication errors, could be reduced if medication errors can be prevent or ameliorate. We investigated the burden of preventable ADEs on the length of hospital stay (LOS) and costs, and estimated the national burden of preventable ADEs in pediatric inpatients in Japan. We analyzed data from the Japan Adverse Drug Events (JADE) study on pediatric patients and estimated the incidence of preventable ADEs and associated extended LOS. Costs attributable to extended LOS by preventable ADEs were calculated using a national statistics database and we calculated the effect of preventable ADEs on national cost excess. We included 907 patients with 7377 patient-days. Among them, 31 patients (3.4%) experienced preventable ADEs during hospitalization. Preventable ADEs significantly increased the LOS by 14.1 days, adjusting for gender, age, ward, resident physician, surgery during hospitalization, cancer, and severe malformation at birth. The individual cost due to the extended LOS of 14.1 days was estimated as USD 8258. We calculated the annual extra expense for preventable ADEs in Japan as USD 329 676 760. Sensitivity analyses, considering the incidence of preventable ADEs and the length of hospital stay, showed that the expected range of annual extra expense for preventable ADEs in Japan is between USD 141 468 968 and 588 450 708. Preventable ADEs caused longer hospitalization and considerable extra healthcare costs in pediatric inpatients. Our results would encourage further efforts to prevent and ameliorate preventable ADEs.