Economic Impact of Emergency Visits due to Drug-Related Morbidity on a Brazilian Hospital.

OBJECTIVES

To estimate the cost of managing drug-related morbidity (DRM) that leads to visits to the emergency department of a Brazilian hospital.

METHODS

This is a cost-of-illness study based on a retrospective cross-sectional analysis of patients' medical records. A questionnaire and analysis of medical records were used to identify patients who were being admitted to the emergency department because of DRM. The direct medical costs of patient management were estimated using a microcosting analysis, and a sensitivity analysis was conducted using the emergency department visit rates due to DRM reported in the literature.

RESULTS

Of the total patients interviewed, 14.6% sought emergency care because of DRM and 58.9% were considered preventable. Mean treatment costs were US $900 ± $1,569 (range US $18-$10,847). An extrapolation based on all emergency visits in the last year resulted in annual total treatment costs of US $7.5 million (US $1.1-$1.4 million). It was observed that 39.3% of the total cost of DRM was attributed to adverse drug reactions, 36.9% to nonadherence to treatment, and 16.9% to incorrect dosages.

CONCLUSIONS

Adverse drug reactions and nonadherence to treatment are important causes of morbidity and cost to the health service. Much of this resource is spent to treat preventable cases of DRM, which represents a great waste of resources.