title: Healthy Life-Years Lost and Excess Bed-Days Due to 6 Patient Safety Incidents: Empirical Evidence From English Hospitals.
abstract: BACKGROUND
  There is little satisfactory evidence on the harm of safety incidents to patients, in terms of lost potential health and life-years.
  
  
  OBJECTIVE
  To estimate the healthy life-years (HLYs) lost due to 6 incidents in English hospitals between the years 2005/2006 and 2009/2010, to compare burden across incidents, and estimate excess bed-days.
  
  
  METHODS
  The study used cross-sectional analysis of the medical records of all inpatients treated in 273 English hospitals. Patients with 6 types of preventable incidents were identified. Total attributable loss of HLYs was estimated through propensity score matching by considering the hypothetical remaining length and quality of life had the incident not occurred.
  
  
  RESULTS
  The 6 incidents resulted in an annual loss of 68 HLYs and 934 excess bed-days per 100,000 population. Preventable pressure ulcers caused the loss of 26 HLYs and 555 excess bed-days annually. Deaths in low-mortality procedures resulted in 25 lost life-years and 42 bed-days. Deep-vein thrombosis/pulmonary embolisms cost 12 HLYs, and 240 bed-days. Postoperative sepsis, hip fractures, and central-line infections cost <6 HLYs and 100 bed-days each.
  
  
  CONCLUSIONS
  The burden caused by the 6 incidents is roughly comparable with the UK burden of Multiple Sclerosis (80 DALYs per 100,000), HIV/AIDS and Tuberculosis (63 DALYs), and Cervical Cancer (58 DALYs). There were marked differences in the harm caused by the incidents, despite the public attention all of them receive. Decision makers can use the results to prioritize resources into further research and effective interventions.
authors.affiliation: *Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London †Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford ‡Imperial College Business School, Imperial College London, London, UK.
authors.forename: Katharina D
authors.initials: KD
authors.lastname: Hauck
authors.forename: Shaolin
authors.initials: S
authors.lastname: Wang
authors.forename: Charles
authors.initials: C
authors.lastname: Vincent
authors.forename: Peter C
authors.initials: PC
authors.lastname: Smith
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004739:England; D006739:Hospital Administration / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D003668:Pressure Ulcer / Q000453:epidemiology; D011655:Pulmonary Embolism / Q000453:epidemiology; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D020246:Venous Thrombosis / Q000453:epidemiology