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[可预防的药物不良事件造成的直接成本及对医院病死率和发病率的影响]

[Direct costs and hospital morbimortality impact from preventable adverse drug events].

作者信息

Pinzón José Fernando, Maldonado Carlos, Díaz Jorge A, Segura Omar

机构信息

Departamento de Farmacia, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.

出版信息

Biomedica. 2011 Jul-Sep;31(3):307-15. doi: 10.1590/S0120-41572011000300003.

Abstract

INTRODUCTION

Implementing pharmacovigilance activities consists of monitoring and assessment of activities related to medical attention. However, additional data are necessary to identify conditions where care quality can be improved. Therefore, a focus on adverse drug events analysis from a prevention and economic perspective is needed, with emphasis on its local impact.

OBJECTIVE

Preventable adverse drug events were summarized to establishing their impact on morbidity and mortality, as well as to estimate the ensuing economic burden.

MATERIALS AND METHODS

The data were gathered from a level 3 hospital (high complexity), located in Bogotá, Colombia, where specific pharmacovigilance activities were recorded in 2007. Patient charts were reviewed to characterize adverse drug events according to their causality, severity and preventability. Direct costs were estimated by grouping diagnostic tests, length of hospitalization, procedures and additional drugs required.

RESULTS

The charts of 283 patients and 448 reports were analyzed. These data indicated that 24.8% of adverse drug events were preventable and that an associated mortality of 1.1% had occurred. The associated direct costs were between USD $16,687 and $18,739. Factors more commonly associated with preventability were drug-drug interactions, as well as inappropriate doses and unsuitable frequencies at which the drugs were administrated.

CONCLUSIONS

The data recommended that actions be taken to decrease preventable adverse drug events, because of negative impact on patient´s health, and unnecessary consumption of healthcare resources.

摘要

引言

实施药物警戒活动包括对与医疗护理相关的活动进行监测和评估。然而,需要更多数据来确定可改善护理质量的情况。因此,有必要从预防和经济角度关注药物不良事件分析,并强调其对当地的影响。

目的

总结可预防的药物不良事件,以确定其对发病率和死亡率的影响,并估计随之而来的经济负担。

材料与方法

数据收集自位于哥伦比亚波哥大的一家三级医院(高复杂性),该医院在2007年记录了特定的药物警戒活动。审查患者病历,根据药物不良事件的因果关系、严重程度和可预防性对其进行特征描述。通过对诊断检查、住院时间、手术和所需额外药物进行分组来估计直接成本。

结果

分析了283名患者的病历和448份报告。这些数据表明,24.8%的药物不良事件是可预防的,且已发生1.1%的相关死亡率。相关直接成本在16,687美元至18,739美元之间。与可预防性更常见相关的因素是药物相互作用,以及药物给药剂量不当和频率不合适。

结论

数据表明应采取行动减少可预防的药物不良事件,因为其对患者健康有负面影响,且会造成医疗资源的不必要消耗。

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