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Frequency and Impact of Adverse Events in Inpatients: A Nationwide Analysis of Episodes between 2000 and 2015

  • Systems-level quality improvement
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Abstract

Despite being a potential cause of morbidity and economic costs, adverse events remain insufficiently studied. Therefore, we aimed to assess the frequency and impact of adverse events among inpatients. We analysed an administrative database containing a registration of all hospitalisations occurring in Portuguese public hospitals between 2000 and 2015. We identified all episodes with a registration of adverse events, and classified them into three categories, namely (1) misadventures of surgical and medical care, (2) complications of surgical or medical procedures, and (3) adverse drug events (including adverse drug reactions, poisoning events, and late effects). These episodes were compared over their length of stay, in-hospital mortality, and hospital costs with an equal number of hospitalisations matched for patients’ and episodes’ characteristics. Between 2000 and 2015, 5.8% (n = 861,372) of all Portuguese hospitalisations had a registration of at least one adverse event. Hospitalisations with registration of adverse events had a median length of stay of 8 days, median hospitalisation costs of 3060.7 Euro, and an in-hospital mortality of 6.7%. Hospitalisations with registration of misadventures of care, complications of procedures and adverse drug reactions had significantly higher lengths of stay and hospitalisation costs than their matched controls. In-hospital mortality was significantly higher for episodes of misadventures of care and complications of procedures, but lower for adverse drug events hospitalisations. Therefore, adverse events are common among inpatients, and have an important clinical and economic impact. Administrative databases may be useful in their epidemiological assessment.

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Acknowledgements

The authors wish to thank the project “NORTE-01-0145-FEDER-000016” (NanoSTIMA), financed by the North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF); the project had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors would also like to thank to the Central Authority for Health Services, I.P. (ACSS) for providing access to the data.

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Authors and Affiliations

  1. MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Rua Dr. Placido da Costa, 4200-450, Porto, Portugal

    Bernardo Sousa-Pinto, Bernardo Marques, Fernando Lopes & Alberto Freitas

  2. CINTESIS – Center for Health Technology and Services Research, Rua Dr. Placido da Costa, 4200-450, Porto, Portugal

    Bernardo Sousa-Pinto, Bernardo Marques, Fernando Lopes & Alberto Freitas

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  1. Bernardo Sousa-Pinto
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Correspondence to Alberto Freitas.

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Sousa-Pinto, B., Marques, B., Lopes, F. et al. Frequency and Impact of Adverse Events in Inpatients: A Nationwide Analysis of Episodes between 2000 and 2015. J Med Syst 42, 48 (2018). https://doi.org/10.1007/s10916-018-0898-5

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