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Adverse Drug Events Raise ED Costs, Hospitalizations

Christine Leccese for HealthLeaders Media, February 28, 2011

Research published in the current issue of the Annals of Emergency Medicine reveals that emergency department (ED) patients who visit because of an adverse drug event (ADE) are significantly more expensive to the healthcare system than other ED patients.  The research, done at Vancouver General Hospital, is the first of its kind to directly compare costs of the two groups.

Researchers found that while there was no difference in mortality rates between the two groups, the group with ADE had a 50% greater risk of spending additional days in the hospital, and a 20% greater need for outpatient healthcare.

The study controlled for baseline differences such as age, gender, previous health conditions, whether a patient was monitored by a primary care physician, and elicit drug use. One thousand Vancouver General Hospital ED patients were followed for six months.

"The most common events were adverse drug reactions. Those accounted for about 40% of all those events. Another 30% were attributed to non-compliance, "explained Corrine Hohl, MD, an emergency physician at Vancouver General Hospital and a researcher at the Centre for Clinical Epidemiology and Evaluation at Vancouver Coastal Health and the University of British Columbia, and the lead researcher on the study.

"The rest of the events," she said," were in several smaller subcategories such as prescribing errors, dispensing errors, an interaction with another drug, or inappropriate medication use given the patient's co-morbid conditions."

As for which medications were most commonly the culprits, Dr. Hohl said that antibiotics, analgesics, cardiovascular drugs, and drugs for hyperglycemia were commonly seen. "The general rule was that if it was commonly prescribed, we saw a lot of adverse drug events from it."

Although the research was done in Canada, the United States sees a significant amount of ADEs, too. The Agency for Health Care Quality and Research reports that more than 770,000 people die or are injured as a result of an ADE in American hospitals each year.

This costs each hospital an average of $5.6 million, depending on it size. Among other pieces of information, the agency reports that patients who experienced an ADE were hospitalized an average of 8 to 12 days longer than those who did not, and their hospitalizations cost $16,000 to $24,000 more.

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