Association of preventable adverse drug events with inpatients' length of stay

• Verfasst von: Amelung, Stefanie [VerfasserIn]
• Verfasst von: Meid, Andreas [VerfasserIn]
• Verfasst von: Nafe, Michael [VerfasserIn]
• Verfasst von: Thalheimer, Markus [VerfasserIn]
• Verfasst von: Hoppe-Tichy, Torsten [VerfasserIn]
• Verfasst von: Haefeli, Walter E. [VerfasserIn]
• Verfasst von: Seidling, Hanna [VerfasserIn]
• Titel: Association of preventable adverse drug events with inpatients' length of stay
• Titelzusatz: a propensity-matched cohort study
• Verf.angabe: Stefanie Amelung, Andreas D. Meid, Michael Nafe, Markus Thalheimer, Torsten Hoppe-Tichy, Walter E. Haefeli, Hanna M. Seidling
• E-Jahr: 2017
• Jahr: 05 September 2017
• Umfang: 9 S.
• Fussnoten: Gesehen am 22.05.2018
• Titel Quelle: Enthalten in: The international journal of clinical practice
• Ort Quelle: London : Hindawi Limited, 2004
• Jahr Quelle: 2017
• Band/Heft Quelle: 71(2017,10) Artikel-Nummer e12990, 9 Seiten
• ISSN Quelle: 1742-1241
• DOI: doi:10.1111/ijcp.12990
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1575387905

Abstract

PURPOSE: Using clinical administrative data (CAD) of inpatients, we aimed to identify ICD-10 codes coding for potentially preventable inhospital adverse drug events (ADE) that affect the length of hospital stay (LOS) and thus patient well-being and cost. METHODS: We retrospectively assessed CAD of all inpatient stays in 2012 of a German university hospital. Predefined ICD-10 codes indicating ADE (ADE codes) were further specified based on expert ratings of the ADE mechanism and ADE preventability in clinical routine to particularly identify preventable inhospital ADE. In a propensity-matched cohort design, we compared patients with one or more ADE codes to control patients with regard to differences in LOS for three situations: all cases with an ADE code, cases with an inhospital ADE code, and cases with a preventable inhospital ADE code. RESULTS: Out of 54 032 cases analysed, in 8.3% (N=4 462) at least one ADE code was present. Nine of 128 evaluated ADE codes were rated as preventable in clinical routine, relating to 220 inpatients (4.9% of all identified inpatients with at least one ADE code and 0.4% of the entire cohort, respectively). Out of 48 072 evaluable inpatients for propensity score matching, 7 938 controls without ADE code and 4 006 cases with ADE code were selected. In all three settings, cases showed prolonged LOS vs controls (delta 1.13 d; 0.88 d and 1.88 d, respectively), significantly exceeding the maximum LOS as defined for each Diagnosis-Related Group. CONCLUSION: Inpatients with ADE codes referring to inhospital, potentially preventable ADE exceeded the maximum hospital stay fully reimbursed by insurance companies, indicating unnecessary long and costly inpatient stays.