title: [Assessing the economic impact of adverse events in Spanish hospitals by using administrative data].
abstract: OBJECTIVE
  To evaluate the incidence and costs of adverse events registered in an administrative dataset in Spanish hospitals from 2008 to 2010.
  
  
  METHODS
  A retrospective study was carried out that estimated the incremental cost per episode, depending on the presence of adverse events. Costs were obtained from the database of the Spanish Network of Hospital Costs. This database contains data from 12 hospitals that have costs per patient records based on activities and clinical records. Adverse events were identified through the Patient Safety Indicators (validated in the Spanish Health System) created by the Agency for Healthcare Research and Quality together with indicators of the EuroDRG European project.
  
  
  RESULTS
  This study included 245,320 episodes with a total cost of 1,308,791,871€. Approximately 17,000 patients (6.8%) experienced an adverse event, representing 16.2% of the total cost. Adverse events, adjusted by diagnosis-related groups, added a mean incremental cost of between €5,260 and €11,905. Six of the 10 adverse events with the highest incremental cost were related to surgical interventions. The total incremental cost of adverse events was € 88,268,906, amounting to an additional 6.7% of total health expenditure.
  
  
  CONCLUSIONS
  Assessment of the impact of adverse events revealed that these episodes represent significant costs that could be reduced by improving the quality and safety of the Spanish Health System.
authors.affiliation: Servicio de Control de Gestión, Hospital del Mar-Parc de Salut MAR, Barcelona, España; Servicio de Epidemiología y Evaluación, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España; Unidad Docente de Medicina Preventiva y Salud Pública Hospital del Mar-Universitat Pompeu Fabra, Agència de Salut Pública de Barcelona, Barcelona, España; Programa de doctorado en Salud Pública, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Natalia
authors.initials: N
authors.lastname: Allué
authors.affiliation: Servicio de Control de Gestión, Hospital del Mar-Parc de Salut MAR, Barcelona, España; Servicio de Epidemiología y Evaluación, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España; Programa de doctorado en Salud Pública, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España.
authors.forename: Pietro
authors.initials: P
authors.lastname: Chiarello
authors.affiliation: Instituto de Investigación Sanitaria de Aragón (ISS Aragón), Zaragoza, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España.
authors.forename: Enrique
authors.initials: E
authors.lastname: Bernal Delgado
authors.affiliation: Servicio de Epidemiología y Evaluación, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Castells
authors.affiliation: Servicio de Epidemiología y Evaluación, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España.
authors.forename: Priscila
authors.initials: P
authors.lastname: Giraldo
authors.affiliation: Instituto de Investigación Sanitaria de Aragón (ISS Aragón), Zaragoza, España.
authors.forename: Natalia
authors.initials: N
authors.lastname: Martínez
authors.affiliation: Servicio de Documentación Clínica, Hospital del Mar-Parc de Salut MAR, Barcelona, España.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Sarsanedas
authors.affiliation: Servicio de Control de Gestión, Hospital del Mar-Parc de Salut MAR, Barcelona, España; Servicio de Epidemiología y Evaluación, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España. Electronic address: fcots@parcdesalutmar.cat.
authors.forename: Francesc
authors.initials: F
authors.lastname: Cots
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007049:Iatrogenic Disease / Q000191:economics* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology*; D012189:Retrospective Studies; D013030:Spain
keywords: Adverse events; Calidad asistencial; Economic evaluation; Economic impact; Evaluación económica; Eventos adversos; Impacto económico; Indicadores de seguridad de los pacientes; Patient safety indicators; Quality of care