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Assessing the excess costs of different in-hospital adverse events covered by the patient safety indicators

Authors: Giese, Alice Neva; Khanam, Rasheda; Nghiem, Son; Staines, Anthony; Rosemann, Thomas; Boes, Stefan; Havranek, Michael M.;

Assessing the excess costs of different in-hospital adverse events covered by the patient safety indicators

Abstract

There currently exists no comprehensive and up-to date overview on the financial impact of the different adverse events covered by the patient safety indicators (PSIs) from the Agency for Healthcare Research and Quality. We conducted a retrospective case-control study using propensity score matching on a national administrative data set of 1 million inpatients in Switzerland to compare excess costs associated with 16 different adverse events both individually and on a nationally aggregated level. After matching 8,986 cases with adverse events across the investigated PSIs to 26,931 controls, we used regression analyses to determine excess costs associated with the adverse events and to control for other cost-related influences. Average excess costs associated with the PSI-related adverse events ranged from CHF 1,211 (PSI 18, obstetric trauma with instrument) to CHF 137,967 (PSI 10, postoperative acute kidney injuries) with an average of CHF 27,409 across all PSIs. In addition, adverse events were associated with 7.8-day longer stays, 2.5 times more readmissions, and 4.1 times higher mortality rates on average. At a national level, the PSIs were associated with CHF 347 million higher inpatient costs in 2019, which corresponds to about 2.2% of the annual inpatient costs in Switzerland. By comparing the excess costs of different PSIs on a nationally aggregated level, we offer a financial perspective on the implications of in-hospital adverse events and provide recommendations for policymakers regarding specific investments in patient safety to reduce costs and suffering.

+ ID der Publikation: unilu_64082 + Sprache: Englisch + Letzte Aktualisierung: 2023-02-20 09:30:12

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Switzerland
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Keywords

Patient safety indicators (PSIs), adverse events, costs, mortality, length of stay (LOS), propensity score matching, Patient safety indicators (PSIs), adverse events, costs, mortality, length of stay (LOS), propensity score matching

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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