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Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes
OBJECTIVE: The aim of this study was to determine the impact of all-cause inpatient harms on hospital finances and patient clinical outcomes. RESEARCH DESIGN: A retrospective analysis of inpatient harm from 24 hospitals in a large multistate health system was conducted during 2009 to 2012 using the...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965919/ https://www.ncbi.nlm.nih.gov/pubmed/25803176 http://dx.doi.org/10.1097/PTS.0000000000000171 |
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author | Adler, Lee Yi, David Li, Michael McBroom, Barry Hauck, Loran Sammer, Christine Jones, Cason Shaw, Terry Classen, David |
author_facet | Adler, Lee Yi, David Li, Michael McBroom, Barry Hauck, Loran Sammer, Christine Jones, Cason Shaw, Terry Classen, David |
author_sort | Adler, Lee |
collection | PubMed |
description | OBJECTIVE: The aim of this study was to determine the impact of all-cause inpatient harms on hospital finances and patient clinical outcomes. RESEARCH DESIGN: A retrospective analysis of inpatient harm from 24 hospitals in a large multistate health system was conducted during 2009 to 2012 using the Institute of Healthcare Improvement Global Trigger Tool for Measuring Adverse Events. Inpatient harms were detected and categorized into harm (F–I), temporary harm (E), and no harm. RESULTS: Of the 21,007 inpatients in this study, 15,610 (74.3%) experienced no harm, 2818 (13.4%) experienced temporary harm, and 2579 (12.3%) experienced harm. A patient with harm was estimated to have higher total cost ($4617 [95% confidence interval (CI), $4364 to 4871]), higher variable cost ($1774 [95% CI, $1648 to $1900]), lower contribution margin (−$1112 [95% CI, −$1378 to −$847]), longer length of stay (2.6 d [95% CI, 2.5 to 2.8]), higher mortality probability (59%; odds ratio, 1.4 [95% CI, 1.0 to 2.0]), and higher 30-day readmission probability (74.4%; odds ratio, 2.9 [95% CI, 2.6 to 3.2]). A patient with temporary harm was estimated to have higher total cost ($2187 [95% CI, $2008 to $2366]), higher variable cost ($800 [95% CI, $709 to $892]), lower contribution margin (−$669 [95% CI, −$891 to −$446]), longer length of stay (1.3 d [95% CI, 1.2 to 1.4]), mortality probability not statistically different, and higher 30-day readmission probability (54.6%; odds ratio, 1.2 [95% CI, 1.1 to 1.4]). Total health system reduction of harm was associated with a decrease of $108 million in total cost, $48 million in variable cost, an increase of contribution margin by $18 million, and savings of 60,000 inpatient care days. CONCLUSIONS: This all-cause harm safety study indicates that inpatient harm has negative financial outcomes for hospitals and negative clinical outcomes for patients. |
format | Online Article Text |
id | pubmed-5965919 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-59659192018-06-01 Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes Adler, Lee Yi, David Li, Michael McBroom, Barry Hauck, Loran Sammer, Christine Jones, Cason Shaw, Terry Classen, David J Patient Saf Original Articles OBJECTIVE: The aim of this study was to determine the impact of all-cause inpatient harms on hospital finances and patient clinical outcomes. RESEARCH DESIGN: A retrospective analysis of inpatient harm from 24 hospitals in a large multistate health system was conducted during 2009 to 2012 using the Institute of Healthcare Improvement Global Trigger Tool for Measuring Adverse Events. Inpatient harms were detected and categorized into harm (F–I), temporary harm (E), and no harm. RESULTS: Of the 21,007 inpatients in this study, 15,610 (74.3%) experienced no harm, 2818 (13.4%) experienced temporary harm, and 2579 (12.3%) experienced harm. A patient with harm was estimated to have higher total cost ($4617 [95% confidence interval (CI), $4364 to 4871]), higher variable cost ($1774 [95% CI, $1648 to $1900]), lower contribution margin (−$1112 [95% CI, −$1378 to −$847]), longer length of stay (2.6 d [95% CI, 2.5 to 2.8]), higher mortality probability (59%; odds ratio, 1.4 [95% CI, 1.0 to 2.0]), and higher 30-day readmission probability (74.4%; odds ratio, 2.9 [95% CI, 2.6 to 3.2]). A patient with temporary harm was estimated to have higher total cost ($2187 [95% CI, $2008 to $2366]), higher variable cost ($800 [95% CI, $709 to $892]), lower contribution margin (−$669 [95% CI, −$891 to −$446]), longer length of stay (1.3 d [95% CI, 1.2 to 1.4]), mortality probability not statistically different, and higher 30-day readmission probability (54.6%; odds ratio, 1.2 [95% CI, 1.1 to 1.4]). Total health system reduction of harm was associated with a decrease of $108 million in total cost, $48 million in variable cost, an increase of contribution margin by $18 million, and savings of 60,000 inpatient care days. CONCLUSIONS: This all-cause harm safety study indicates that inpatient harm has negative financial outcomes for hospitals and negative clinical outcomes for patients. Lippincott Williams & Wilkins 2018-06 2015-03-23 /pmc/articles/PMC5965919/ /pubmed/25803176 http://dx.doi.org/10.1097/PTS.0000000000000171 Text en Copyright © 2015 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Articles Adler, Lee Yi, David Li, Michael McBroom, Barry Hauck, Loran Sammer, Christine Jones, Cason Shaw, Terry Classen, David Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes |
title | Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes |
title_full | Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes |
title_fullStr | Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes |
title_full_unstemmed | Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes |
title_short | Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes |
title_sort | impact of inpatient harms on hospital finances and patient clinical outcomes |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965919/ https://www.ncbi.nlm.nih.gov/pubmed/25803176 http://dx.doi.org/10.1097/PTS.0000000000000171 |
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