Medication errors resulting in harm: Using chargemaster data to determine association with cost of hospitalization and length of stay

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Abstract

Purpose.

Results of an analysis of the economic impact of adverse drug events (ADEs) resulting in patient harm on hospitalization costs and length of stay (LOS) are reported.

Methods.

In a retrospective single-site study, medication errors among patients admitted to an academic medical center during the period April 2014–May 2015 were identified using voluntary event reporting system data and diagnosis codes. Hospitalization cases involving documented ADEs resulting in harm, as defined on a widely used medication error classification index, were matched with control cases by admission period, diagnosis-related group, and patient age and sex. Total hospitalization costs and LOS in the study groups were analyzed using an independent 2-sample Mann–Whitney U test.

Results.

Among 416 hospitalization cases evaluated for inclusion in the study, 242 were matched with 3,279 control cases for analysis. The primary drug classes implicated in the evaluated medication errors included chemotherapy agents (38%), corticosteroids (14%), and opioids (11%). Total hospitalization costs differed significantly (p = 0.044) between patients who experienced ADEs resulting in harm (median, $19,444; interquartile range [IQR], $13,481–$40,580) and those who did not (median, $17,173; IQR, $12,500–$27,125); the former group also had a significantly (p = 0.005) longer median LOS.

Conclusion.

Chargemaster data for an academic medical center revealed that the median total hospitalization cost and LOS were significantly greater for hospitalizations during which a harm-causing medication error was recorded versus hospitalizations during which harm-causing medication errors were not recorded.

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