Direct health care costs of hospital admissions due to adverse events in The Netherlands.
BACKGROUND
Health care-related adverse events (AEs) are common, and the economic burden is substantial. Information on costs of health care-related AEs 'leading' to hospitalization is limited and has focused on adverse drug events.


OBJECTIVE
To provide insight into costs of admissions due to (preventable) health care-related AEs, not limited to adverse drug events.


METHODS
This study was conducted during a 5-month period (May-September 2010) in The Netherlands, in a 600-bed university medical centre. All patients who were admitted via the emergency department to an internal medicine department because of a health care-related AE were included. We retrospectively retrieved all data on medical information as well as health care resource utilization from the patient's medical record. The cost of the admission was estimated (for each patient individually) by multiplying the number of resources by their specific unit cost and then summing all costs per patient.


RESULTS
In total, 324 admissions due to a health care-related AE were included (28.7% of all admissions). Total direct health care costs of these hospitalizations amounted to €1,404,070 in a 5-month period. Medication-related AEs were most common (43.5%) and contributed most to the costs (€587,550; 41.8%). Inpatient days were most expensive (€1,076,385; 77.3%). Preventable health care-related AEs accounted for €277,665 (19.8%).


CONCLUSIONS
We found that health care-related AEs are expensive, with preventable health care-related AEs accounting for one-fifth of the costs. Awareness of possible health care-related AEs following medical actions is necessary to reduce already high health care costs.
1 Division of General Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands fabienne.magdelijns@mumc.nl.
Fabienne J H
FJ
Magdelijns
1 Division of General Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands 2 Division of Acute Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands 3 School of CAPHRI, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands.
Patricia M
PM
Stassen
1 Division of General Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands 4 Cardiovascular Research Institute, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands.
Coen D A
CD
Stehouwer
1 Division of General Medicine, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands 5 Section of Clinical Geriatric Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands.
Evelien
E
Pijpers
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008485:Medical Audit; D019300:Medical Errors / Q000191:economics*; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies