Walsh Elaine K, Hansen Christina Raae, Sahm Laura J, Kearney Patricia M, Doherty Edel, Bradley Colin P
Department of General Practice, University College Cork, Cork, Ireland.
School of Pharmacy, University College Cork, Cork, Ireland.
Pharmacoepidemiol Drug Saf. 2017 May;26(5):481-497. doi: 10.1002/pds.4188. Epub 2017 Mar 13.
Medication error is a significant source of morbidity and mortality among patients. Clinical and cost-effectiveness evidence are required for the implementation of quality of care interventions. Reduction of error-related cost is a key potential benefit of interventions addressing medication error. The aim of this review was to describe and quantify the economic burden associated with medication error.
PubMed, Cochrane, Embase, CINAHL, EconLit, ABI/INFORM, Business Source Complete were searched. Studies published 2004-2016 assessing the economic impact of medication error were included. Cost values were expressed in Euro 2015. A narrative synthesis was performed.
A total of 4572 articles were identified from database searching, and 16 were included in the review. One study met all applicable quality criteria. Fifteen studies expressed economic impact in monetary terms. Mean cost per error per study ranged from €2.58 to €111 727.08. Healthcare costs were used to measure economic impact in 15 of the included studies with one study measuring litigation costs. Four studies included costs incurred in primary care with the remaining 12 measuring hospital costs. Five studies looked at general medication error in a general population with 11 studies reporting the economic impact of an individual type of medication error or error within a specific patient population.
Considerable variability existed between studies in terms of financial cost, patients, settings and errors included. Many were of poor quality. Assessment of economic impact was conducted predominantly in the hospital setting with little assessment of primary care impact. Limited parameters were used to establish economic impact. Copyright © 2017 John Wiley & Sons, Ltd.
用药错误是患者发病和死亡的一个重要原因。实施医疗质量干预措施需要临床和成本效益证据。降低与错误相关的成本是解决用药错误干预措施的一个关键潜在益处。本综述的目的是描述和量化与用药错误相关的经济负担。
检索了PubMed、Cochrane、Embase、CINAHL、EconLit、ABI/INFORM、Business Source Complete。纳入了2004年至2016年发表的评估用药错误经济影响的研究。成本值以2015年欧元表示。进行了叙述性综合分析。
通过数据库检索共识别出4572篇文章，其中16篇纳入综述。一项研究符合所有适用的质量标准。15项研究以货币形式表示经济影响。每项研究中每个错误的平均成本从2.58欧元到111727.08欧元不等。在纳入的15项研究中使用医疗保健成本来衡量经济影响，一项研究衡量诉讼成本。4项研究纳入了初级保健中的成本，其余12项衡量医院成本。5项研究着眼于普通人群中的一般用药错误，11项研究报告了个体用药错误类型或特定患者群体中错误的经济影响。
在财务成本、患者、环境和纳入的错误方面，不同研究之间存在很大差异。许多研究质量较差。经济影响评估主要在医院环境中进行，对初级保健影响的评估很少。用于确定经济影响的参数有限。版权所有©2017约翰威立父子有限公司。
