S2 Statistical Solutions, Inc. , Cincinnati, OH , USA.
J Med Econ. 2013 Dec;16(12):1367-78. doi: 10.3111/13696998.2013.848210. Epub 2013 Oct 17.
The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years.
Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits.
There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population.
This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database.
This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.
本研究的主要目的是量化一般人群和≥65 岁老年人群中医院医疗差错的发生率和成本差异。
使用 2009 年的数据，对医疗差错精算研究中的方法进行了修改，以在 Premier Hospital Database 中识别医疗差错。从人群中删除了有超过 4 个医疗差错的就诊记录，以避免高估成本。基于总住院人数计算发生率。
2009 年共有 3466596 例住院患者。其中，≥65 岁者占 1230836 例（36%）。普通人群的发生率为每千名住院患者发生 49 例医疗差错，老年人群的发生率为每千名住院患者发生 79 例医疗差错。前 10 大医疗差错占普通人群和 65 岁以上人群总差错的 80%以上。普通人群中最昂贵的医疗差错是术后感染（569287000 美元）。压疮在老年人群中最昂贵（347166257 美元）。
本研究使用医院管理数据库进行，因此在数据库中识别医疗差错需要进行假设。此外，该数据库中没有方法可以识别遗漏或误诊的错误。
本研究表明，老年人群中医院医疗差错的发生率高于普通人群，老年人群中医疗差错的相关成本相当可观。如果医院进一步关注老年人群中的医疗差错，由于该年龄段发生的医疗差错比例过高，可能会显著降低因医疗差错而导致的成本。
