Skip to main content
Quality in Health Care : QHC logoLink to Quality in Health Care : QHC
. 2000 Dec;9(4):216–221. doi: 10.1136/qhc.9.4.216

Errors in health care management: what do they cost?

K Rigby 1, J Litt 1
PMCID: PMC1743550  PMID: 11101706

Abstract

J C B Litt, general practitioner and senior lecturer

Background—Iatrogenic injuries are relatively common and a potentially avoidable source of morbidity. The economic evaluation of this area has been limited by the lack of good quality national data to provide an estimate of incidence, associated disability, and preventability of iatrogenic injuries. Two recent surveys, the Quality in Australian Health Care Study (QAHCS) and the Utah Colorado Study (UTCOS), have now made this feasible.

Aims—To determine the direct costs associated with iatrogenic injuries occurring in a hospital setting.

Methods—The QAHCS was used as a representative national source of information on the incidence, disability, and preventability of iatrogenic injuries. Costs were calculated using information from Australian disease related groups (AN-DRGs) relative to the injury categories.

Results—The cost of just 12 preventable iatrogenic injuries is significant (0.25 million US dollars) and accounts for 2–3% of the annual budget of a typical Australian community based hospital of 120 beds. Costing data provide additional useful information for policy and decision makers.

Conclusion—Costing iatrogenic injuries is an important component of the impact of these events. An ongoing national database of iatrogenic injuries is necessary to assist in identifying the incidence of these injuries, monitoring trends, and providing data for cost estimates and economic evaluations.

(Quality in Health Care 2000;9:216–221)

Key Words: iatrogenic injuries; costs

Full Text

The Full Text of this article is available as a PDF (165.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bates D. W., Spell N., Cullen D. J., Burdick E., Laird N., Petersen L. A., Small S. D., Sweitzer B. J., Leape L. L. The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997 Jan 22;277(4):307–311. [PubMed] [Google Scholar]
  2. Bootman J. L., Harrison D. L., Cox E. The health care cost of drug-related morbidity and mortality in nursing facilities. Arch Intern Med. 1997 Oct 13;157(18):2089–2096. [PubMed] [Google Scholar]
  3. Brennan T. A., Leape L. L., Laird N. M., Hebert L., Localio A. R., Lawthers A. G., Newhouse J. P., Weiler P. C., Hiatt H. H. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med. 1991 Feb 7;324(6):370–376. doi: 10.1056/NEJM199102073240604. [DOI] [PubMed] [Google Scholar]
  4. Coello R., Glenister H., Fereres J., Bartlett C., Leigh D., Sedgwick J., Cooke E. M. The cost of infection in surgical patients: a case-control study. J Hosp Infect. 1993 Dec;25(4):239–250. doi: 10.1016/0195-6701(93)90110-l. [DOI] [PubMed] [Google Scholar]
  5. Couch N. P., Tilney N. L., Rayner A. A., Moore F. D. The high cost of low-frequency events: the anatomy and economics of surgical mishaps. N Engl J Med. 1981 Mar 12;304(11):634–637. doi: 10.1056/NEJM198103123041103. [DOI] [PubMed] [Google Scholar]
  6. Darchy B., Le Mière E., Figuérédo B., Bavoux E., Domart Y. Iatrogenic diseases as a reason for admission to the intensive care unit: incidence, causes, and consequences. Arch Intern Med. 1999 Jan 11;159(1):71–78. doi: 10.1001/archinte.159.1.71. [DOI] [PubMed] [Google Scholar]
  7. Drummond M. Cost-of-illness studies: a major headache? Pharmacoeconomics. 1992 Jul;2(1):1–4. doi: 10.2165/00019053-199202010-00001. [DOI] [PubMed] [Google Scholar]
  8. Eckman M. H., Falk R. H., Pauker S. G. Cost-effectiveness of therapies for patients with nonvalvular atrial fibrillation. Arch Intern Med. 1998 Aug 10;158(15):1669–1677. doi: 10.1001/archinte.158.15.1669. [DOI] [PubMed] [Google Scholar]
  9. Gage B. F., Cardinalli A. B., Albers G. W., Owens D. K. Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation. JAMA. 1995 Dec 20;274(23):1839–1845. [PubMed] [Google Scholar]
  10. Gustafsson C., Asplund K., Britton M., Norrving B., Olsson B., Marké L. A. Cost effectiveness of primary stroke prevention in atrial fibrillation: Swedish national perspective. BMJ. 1992 Dec 12;305(6867):1457–1460. doi: 10.1136/bmj.305.6867.1457. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Johnson W. G., Brennan T. A., Newhouse J. P., Leape L. L., Lawthers A. G., Hiatt H. H., Weiler P. C. The economic consequences of medical injuries. Implications for a no-fault insurance plan. JAMA. 1992 May 13;267(18):2487–2492. [PubMed] [Google Scholar]
  12. Leape L. L., Brennan T. A., Laird N., Lawthers A. G., Localio A. R., Barnes B. A., Hebert L., Newhouse J. P., Weiler P. C., Hiatt H. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med. 1991 Feb 7;324(6):377–384. doi: 10.1056/NEJM199102073240605. [DOI] [PubMed] [Google Scholar]
  13. Leape L. L., Lawthers A. G., Brennan T. A., Johnson W. G. Preventing medical injury. QRB Qual Rev Bull. 1993 May;19(5):144–149. doi: 10.1016/s0097-5990(16)30608-x. [DOI] [PubMed] [Google Scholar]
  14. Mol W. E., Egberts T. C. Prophylaxis for venous thromboembolism in hip fracture surgery: total costs and cost effectiveness in The Netherlands. Pharmacoeconomics. 1994 Jan;5(1):48–55. doi: 10.2165/00019053-199405010-00007. [DOI] [PubMed] [Google Scholar]
  15. Sheldon T. Promoting health care quality: what role performance indicators? Qual Health Care. 1998 Dec;7 (Suppl):S45–S50. [PubMed] [Google Scholar]
  16. Unwin E., Codde J. Estimating the cost of hospital treatment for injuries using linked morbidity data. Aust N Z J Public Health. 1998 Aug;22(5):624–626. doi: 10.1111/j.1467-842x.1998.tb01450.x. [DOI] [PubMed] [Google Scholar]
  17. Wilson R. M., Harrison B. T., Gibberd R. W., Hamilton J. D. An analysis of the causes of adverse events from the Quality in Australian Health Care Study. Med J Aust. 1999 May 3;170(9):411–415. doi: 10.5694/j.1326-5377.1999.tb127814.x. [DOI] [PubMed] [Google Scholar]
  18. Wilson R. M., Runciman W. B., Gibberd R. W., Harrison B. T., Newby L., Hamilton J. D. The Quality in Australian Health Care Study. Med J Aust. 1995 Nov 6;163(9):458–471. doi: 10.5694/j.1326-5377.1995.tb124691.x. [DOI] [PubMed] [Google Scholar]

Articles from Quality in Health Care : QHC are provided here courtesy of BMJ Publishing Group

RESOURCES