Magdelijns Fabienne J H, Stassen Patricia M, Stehouwer Coen D A, Pijpers Evelien
1 Division of General Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
1 Division of General Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands 2 Division of Acute Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands 3 School of CAPHRI, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands.
Eur J Public Health. 2014 Dec;24(6):1028-33. doi: 10.1093/eurpub/cku037. Epub 2014 Apr 2.
Health care-related adverse events (AEs) are common, and the economic burden is substantial. Information on costs of health care-related AEs 'leading' to hospitalization is limited and has focused on adverse drug events.
To provide insight into costs of admissions due to (preventable) health care-related AEs, not limited to adverse drug events.
This study was conducted during a 5-month period (May-September 2010) in The Netherlands, in a 600-bed university medical centre. All patients who were admitted via the emergency department to an internal medicine department because of a health care-related AE were included. We retrospectively retrieved all data on medical information as well as health care resource utilization from the patient's medical record. The cost of the admission was estimated (for each patient individually) by multiplying the number of resources by their specific unit cost and then summing all costs per patient.
In total, 324 admissions due to a health care-related AE were included (28.7% of all admissions). Total direct health care costs of these hospitalizations amounted to €1,404,070 in a 5-month period. Medication-related AEs were most common (43.5%) and contributed most to the costs (€587,550; 41.8%). Inpatient days were most expensive (€1,076,385; 77.3%). Preventable health care-related AEs accounted for €277,665 (19.8%).
We found that health care-related AEs are expensive, with preventable health care-related AEs accounting for one-fifth of the costs. Awareness of possible health care-related AEs following medical actions is necessary to reduce already high health care costs.
与医疗保健相关的不良事件（AE）很常见，经济负担巨大。关于“导致”住院的与医疗保健相关不良事件的成本信息有限，且主要集中在药物不良事件上。
深入了解因（可预防的）与医疗保健相关不良事件导致的住院成本，不限于药物不良事件。
本研究于2010年5月至9月在荷兰一家拥有600张床位的大学医学中心进行了为期5个月的研究。纳入所有因与医疗保健相关的不良事件通过急诊科收治到内科的患者。我们从患者病历中回顾性检索了所有医疗信息以及医疗保健资源利用数据。通过将资源数量乘以其特定单位成本，然后汇总每位患者所有成本来估算住院成本（针对每位患者单独估算）。
总共纳入了324例因与医疗保健相关不良事件导致的住院病例（占所有住院病例的28.7%）。在5个月期间，这些住院病例的直接医疗总成本达1,404,070欧元。与药物相关的不良事件最为常见（43.5%），且对成本贡献最大（587,550欧元；41.8%）。住院天数成本最高（1,076,385欧元；77.3%）。可预防的与医疗保健相关不良事件占277,665欧元（19.8%）。
我们发现与医疗保健相关的不良事件成本高昂，其中可预防的与医疗保健相关不良事件占成本的五分之一。为降低本已高昂的医疗保健成本，有必要提高对医疗行为后可能出现的与医疗保健相关不良事件 的认识。
