PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of procascamcLink to Publisher's site
 
Proc Annu Symp Comput Appl Med Care. 1993 : 161–165.
PMCID: PMC2248496

Using a hospital information system to assess the effects of adverse drug events.

Abstract

The most common adverse events experienced by hospitalized patients are drug related. While numerous studies have described the incidence and types of adverse drug events (ADEs), the actual effect of these events on patient outcomes have only been estimated. The studies that have described the effects of ADEs on patient outcomes have not stratified patients by severity of illness and hospital costs were estimated based on a percent of hospital charges. We designed a study to utilize the resources of our hospital information system to assess the attributable effects of ADEs on hospital length of stay and cost of hospitalization. This approach emphasized the difference between study patients and their matched control patients rather than overall differences between patients with and without ADEs. In addition, we used nursing acuity data to help adjust severity of illness within DRG groups and actual hospital costs were used instead of estimated costs. This study found that while the average length of stay for patients with ADEs was 8.19 days compared to 4.36 days for matched control patients, the attributable difference due to the ADEs was 1.94 days. Similar methods found that patients with ADEs had an average cost of hospitalization of $10,584 compared to $5,350 for those without and the attributable difference due to ADEs was $1,939. This indicates that the 569 ADEs at our hospital during 1992 resulted in an additional 1,104 extra patient days at a cost of $1,103,291.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (913K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, Newhouse JP, Weiler PC, Hiatt HH. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med. 1991 Feb 7;324(6):370–376. [PubMed]
  • Jick H. Drugs--remarkably nontoxic. N Engl J Med. 1974 Oct 17;291(16):824–828. [PubMed]
  • Miller RR. Interpretation of studies on adverse drug reactions. Am J Hosp Pharm. 1977 Jul;34(7):753–754. [PubMed]
  • Karch FE, Lasagna L. Adverse drug reactions. A critical review. JAMA. 1975 Dec 22;234(12):1236–1241. [PubMed]
  • Faich GA, Knapp D, Dreis M, Turner W. National adverse drug reaction surveillance: 1985. JAMA. 1987 Apr 17;257(15):2068–2070. [PubMed]
  • Vanputte AW, Sovie MD, Tarcinale MA, Stunden AE. Accounting for patient acuity: the nursing time dimension. Nurs Manage. 1985 Oct;16(10):27–36. [PubMed]
  • Van Ruiswyk J, Hartz A, Guse C, Sigmann P, Porth C, Buck K. Nursing assessments: patient severity of illness. Nurs Manage. 1992 Sep;23(9):44–48. [PubMed]
  • Trofino J. A reality based system for pricing nursing service. Nurs Manage. 1986 Jan;17(1):19–24. [PubMed]
  • Classen DC, Pestotnik SL, Evans RS, Burke JP. Computerized surveillance of adverse drug events in hospital patients. JAMA. 1991 Nov 27;266(20):2847–2851. [PubMed]
  • Evans RS, Larsen RA, Burke JP, Gardner RM, Meier FA, Jacobson JA, Conti MT, Jacobson JT, Hulse RK. Computer surveillance of hospital-acquired infections and antibiotic use. JAMA. 1986 Aug 22;256(8):1007–1011. [PubMed]
  • Horn SD, Bulkley G, Sharkey PD, Chambers AF, Horn RA, Schramm CJ. Interhospital differences in severity of illness. Problems for prospective payment based on diagnosis-related groups (DRGs). N Engl J Med. 1985 Jul 4;313(1):20–24. [PubMed]
  • Gross PA, Beyt BE, Jr, Decker MD, Garibaldi RA, Hierholzer WJ, Jr, Jarvis WR, Larson E, Simmons B, Scheckler WE, Harkavy LM. Description of case-mix adjusters by the Severity of Illness Working Group of the Society of Hospital Epidemiologists of America (SHEA). Infect Control Hosp Epidemiol. 1988 Jul;9(7):309–316. [PubMed]
  • Thomas JW, Ashcraft ML. Measuring severity of illness: six severity systems and their ability to explain cost variations. Inquiry. 1991 Spring;28(1):39–55. [PubMed]
  • Iezzoni LI. Severity of illness measures. Comments and caveats. Med Care. 1990 Sep;28(9):757–761. [PubMed]
  • Rubin HR, Wu AW. The risk of adjustment. Med Care. 1992 Nov;30(11):973–975. [PubMed]
  • Haley RW, Schaberg DR, Von Allmen SD, McGowan JE., Jr Estimating the extra charges and prolongation of hospitalization due to nosocomial infections: a comparison of methods. J Infect Dis. 1980 Feb;141(2):248–257. [PubMed]
  • Horn SD, Horn RA, Sharkey PD, Chambers AF. Severity of illness within DRGs. Homogeneity study. Med Care. 1986 Mar;24(3):225–235. [PubMed]

Articles from Proceedings of the Annual Symposium on Computer Application in Medical Care are provided here courtesy of American Medical Informatics Association