Kjellberg Jakob, Wolf Rasmus Trap, Kruse Marie, Rasmussen Susanne R, Vestergaard Jesper, Nielsen Kent J, Rasmussen Kurt
KORA, the Danish Institute for Local and Regional Government Research, Copenhagen and Aarhus, Købmagergade 22, 1150, Copenhagen K, Denmark.
Department of Occupational Medicine, University Research Clinic, Herning Regional Hospital, Herning, Denmark.
BMC Health Serv Res. 2017 Sep 13;17(1):651. doi: 10.1186/s12913-017-2605-5.
The aim of this study was to analyse the additional treatment costs of acute patients admitted to a Danish hospital who suffered an adverse event (AE) during in-hospital treatment.
A matched case-control design was utilised. Using a combination of trigger words and patient record reviews 91 patients exposed to AEs were identified. Controls were identified among patients admitted to the same department during the same 20-month period. The matching was based on age, gender, and main diagnosis. Cost data was extracted from the Danish National Cost Database for four different periods after beginning of the admission.
Patients exposed to an AE were associated with higher mean cost of EUR 9505 during their index admission (p = 0.014). For the period of 6 months from the beginning of the admission minus the admission itself they were associated with higher mean cost of EUR 4968 (p = 0.016). For the period from the 7th month until the end of the 12th month there was no statistically significant difference (p = 0.104). For the total period of 12 month, patients exposed to an AE were associated with statistically significant higher mean cost of EUR 13,930 (p = 0.001).
AEs are associated with significant hospital costs. Our findings suggest that a follow-up period of 6 months is necessary when investigating the costs associated with AEs among acute patients. Further research of specific types of AEs and the costs of preventing these types of AEs would improve the understanding of the relationship between adverse events and costs.
本研究旨在分析入住丹麦一家医院的急性病患者在住院治疗期间发生不良事件（AE）的额外治疗费用。
采用匹配病例对照设计。通过触发词和患者病历审查相结合的方式，确定了91例发生不良事件的患者。对照组是在同一20个月期间入住同一科室的患者中确定的。匹配基于年龄、性别和主要诊断。从丹麦国家成本数据库中提取入院开始后四个不同时间段的成本数据。
发生不良事件的患者在其首次入院期间的平均费用较高，为9505欧元（p = 0.014）。从入院开始减去入院本身的6个月期间，他们的平均费用较高，为4968欧元（p = 0.016）。从第7个月到第12个月末，没有统计学上的显著差异（p = 0.104）。在12个月的总期间，发生不良事件的患者的平均费用在统计学上显著较高，为13930欧元（p = 0.001）。
不良事件与高昂的医院成本相关。我们的研究结果表明，在调查急性病患者中与不良事件相关的成本时，6个月的随访期是必要的。对特定类型的不良事件以及预防这些类型不良事件的成本进行进一步研究，将有助于更好地理解不良事件与成本之间的关系。
