What do we know about financial returns on investments in patient safety? A literature review.
BACKGROUND
A framework was proposed for making a business case for patient safety interventions and to evaluate whether and how thoroughly financial aspects of investments and returns have been reported.


METHODS
MEDLINE was searched from inception through January 21, 2005. Articles were selected if they reported on a patient safety intervention or a patient safety related outcome within the United States and indicated that a financial or economic analysis of the intervention was an objective.


RESULTS
For 165 articles, a financial or economic analysis was indicated as an objective; 36.4% used original data, 28.5% used referenced data, and 35.2% provided no analysis. Only 13 articles (7.9%) included original data on start-up costs, 45 articles (27.3%) included original data on operating expenses and benefits, and 9 articles (5.5%) provided original financial data on outcomes. Of the 165 articles, 56.4% evaluated technological methods of improving patient safety, such as adoption of computer physician order entry, 20.6% evaluated changes in processes of care, such as staffing changes, and 23% involved other types of interventions or outcomes.


CONCLUSIONS
Few articles provided complete information on the required investment and anticipated return on patient safety interventions. Use of standard financial techniques may strengthen the business case for patient safety interventions.
Schmidek
Jared M
JM
Veterans Health Administration's National Center for Patient Safety, White River Junction, Vermont, USA. jared.schmidek@dartmouth.edu
Weeks
William B
WB
D003365:Costs and Cost Analysis; D006282:Health Personnel / Q000191:economics; D006801:Humans; D007256:Information Systems / Q000191:economics; D010361:Patients; D011787:Quality of Health Care / Q000191:economics*; D017751:Safety Management / Q000191:economics*; D014481:United States