Effects of an adverse-drug-event alert system on cost and quality outcomes in community hospitals.
OBJECTIVE
The effects of an adverse-drug-event (ADE) alert system on cost and quality outcomes in community hospitals were evaluated.


METHODS
This retrospective observational study evaluated the effects of an ADE alert system in seven hospitals in the Trinity Health network. Outcomes for all inpatients admitted to these hospitals after and one year before the deployment of an ADE alert system were evaluated. Inpatients in two network hospitals that lacked any computerized ADE alert system constituted the external control group. Administrative data were gathered for patients from these facilities for the same time frames as for the preimplementation and postimplementation groups. Primary outcomes evaluated included pharmacy department costs, variable drug costs, and mortality rates. Secondary outcomes included total hospitalization costs, length of hospital stay (LOS), rate of readmission, and case-mix index. Mean differences in primary and secondary outcome measures across all four groups were examined using analysis of variance.


RESULTS
Significant decreases in mean pharmacy department costs per patient were observed from preimplementation to postimplementation (p < 0.001), while pharmacy department costs increased significantly in the external control group (p = 0.029). Drug costs decreased significantly from baseline (p < 0.001) in the postimplementation group. Drug costs increased significantly in the external control group (p = 0.029). Severity-adjusted mortality rates and LOS decreased significantly in the postimplementation group. Total patient hospitalization costs, both crude and severity adjusted, significantly increased in both groups.


CONCLUSIONS
Implementation of an ADE alert system in seven community hospitals demonstrated significant decreases in pharmacy department costs, variable drug costs, and severity-adjusted mortality rates.
Piontek
Frank
F
College of William and Mary, Williamsburg, VA, USA.
Kohli
Rajiv
R
Conlon
Paul
P
Ellis
Jeffrey J
JJ
Jablonski
Jason
J
Kini
Narendra
N
D016907:Adverse Drug Reaction Reporting Systems / Q000191:economics / Q000458:organization & administration*; D015982:Bias; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D003953:Diagnosis-Related Groups; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics; D006764:Hospitals, Community / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D010359:Patient Readmission / Q000191:economics; D010607:Pharmacy Service, Hospital / Q000191:economics / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States