Iwasaki Hitoshi, Sakuma Mio, Ida Hiroyuki, Morimoto Takeshi
Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan.
Clin Med Insights Pediatr. 2021 Feb 22;15:1179556521995833. doi: 10.1177/1179556521995833. eCollection 2021.
Adverse drug events (ADEs) are a burden to the healthcare system. Preventable ADEs, which was ADEs due to medication errors, could be reduced if medication errors can be prevent or ameliorate.
We investigated the burden of preventable ADEs on the length of hospital stay (LOS) and costs, and estimated the national burden of preventable ADEs in pediatric inpatients in Japan.
We analyzed data from the Japan Adverse Drug Events (JADE) study on pediatric patients and estimated the incidence of preventable ADEs and associated extended LOS. Costs attributable to extended LOS by preventable ADEs were calculated using a national statistics database and we calculated the effect of preventable ADEs on national cost excess.
We included 907 patients with 7377 patient-days. Among them, 31 patients (3.4%) experienced preventable ADEs during hospitalization. Preventable ADEs significantly increased the LOS by 14.1 days, adjusting for gender, age, ward, resident physician, surgery during hospitalization, cancer, and severe malformation at birth. The individual cost due to the extended LOS of 14.1 days was estimated as USD 8258. We calculated the annual extra expense for preventable ADEs in Japan as USD 329 676 760. Sensitivity analyses, considering the incidence of preventable ADEs and the length of hospital stay, showed that the expected range of annual extra expense for preventable ADEs in Japan is between USD 141 468 968 and 588 450 708.
Preventable ADEs caused longer hospitalization and considerable extra healthcare costs in pediatric inpatients. Our results would encourage further efforts to prevent and ameliorate preventable ADEs.
药物不良事件（ADEs）给医疗系统带来负担。如果能够预防或改善因用药错误导致的可预防ADEs，那么这类事件是可以减少的。
我们调查了可预防ADEs对住院时间（LOS）和费用的负担，并估算了日本儿科住院患者中可预防ADEs的全国负担。
我们分析了日本药物不良事件（JADE）研究中儿科患者的数据，估算了可预防ADEs的发生率以及相关的住院时间延长情况。使用国家统计数据库计算了可预防ADEs导致的住院时间延长所产生的费用，并计算了可预防ADEs对国家费用超支的影响。
我们纳入了907例患者，共7377个患者日。其中，31例患者（3.4%）在住院期间发生了可预防ADEs。在对性别、年龄、病房、住院医师、住院期间手术、癌症和出生时严重畸形进行调整后，可预防ADEs使住院时间显著延长了14.1天。因住院时间延长14.1天产生的个人费用估计为8258美元。我们计算出日本每年因可预防ADEs产生的额外费用为329676760美元。考虑到可预防ADEs的发生率和住院时间的敏感性分析表明，日本每年因可预防ADEs产生的额外费用预期范围在141468968美元至588450708美元之间。
可预防ADEs导致儿科住院患者住院时间延长和产生相当多的额外医疗费用。我们的结果将鼓励进一步努力预防和改善可预防ADEs。
