Get access

Measuring the cost of hospital adverse patient safety events

Authors

  • Kathleen Carey,

    Corresponding author
    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Public Health, Boston, MA, USA
    • VA Center for Health Quality, Outcomes and Economic Research, 200 Springs Road, Bedford, MA 01730, USA
    Search for more papers by this author
  • Theodore Stefos

    1. VA Office of Productivity, Efficiency and Staffing, Bedford, MA, USA
    2. Boston University School of Public Health, Boston, MA, USA
    Search for more papers by this author

  • This article is a U.S. Government work and is in the public domain in the U.S.A.

Abstract

This paper estimates the excess cost of hospital inpatient care due to adverse safety events in the US Department of Veterans Affairs (VA) hospitals during fiscal year 2007. We measured adverse events according to the Patient Safety Indicator (PSI) algorithms of the Agency for Healthcare Research and Quality. Patient level cost regression analyses were performed using generalized linear modeling techniques. Accounting for the heavily skewed distribution of costs among patients having adverse safety events, results suggested that the excess cost of nine different PSIs for VA patients are much higher than previously estimated. We tested sensitivity of results to whether costs were measured by VA's Decision Support System (DSS) that uses local costs of specific inputs, or by the average costing system developed by VA's Health Economics Resource Center. DSS costing appeared to better characterize the high cost patients. Published in 2010 by John Wiley & Sons, Ltd.

Ancillary