Cost of medication errors

Medication errors are costly to both the patient (direct costs such as additional treatment and increased hospital stay) and to society (indirect costs such as decreased employment, costs of litigation) [1,5]. The cost of medication errors in a 700-bed teaching hospital based on a study in eleven medical and surgical units in two hospitals over a six-month period, was estimated to be 2.8 million dollars annually [2]. The increased length of stay associated with a medication error was estimated to be 4.6 days [2]. In a four-year study of the eosts of adverse drug events (ADEs) in a tertiary care center, 1% of these events were elassified as medication errors. The excess hospital costs for ADEs over the study period were almost 4,500,000 with almost 4,000 days of increased hospital stay [12]. 

As the volume and potency of prescription medications have increased, the nation s attention has become focused on the staggering human and economic cost of medication errors. Drug-related morbidity and mortality in the United States has a vast economic impact on the healthcare system. The nation was stunned in 1999 when the Institute of Medicine (lOM) issued a report that concluded that medical errors account for between 44,000 and 98,000 deaths annually. The lOM report noted that [bjecause... 

The difficulty in all current medical systems is that information overload, the high human and financial costs of medical errors and adverse drug responses (ADRs), and the need for speed, mean that physicians cannot practice high-quality evidence-based medicine (see Chapter 10 for the increasingly popular formal form of this) unless they move toward having decision support systems at the point of care. Such IT will naturally render the system more holistic because it can collate all data. However, if we are to consciously and aggressively go for a holistic form of medicine, then the need to achieve a more... 

Medication errors are costly and are a diversion from the intended therapeutic objective. Morbidity or mortality are possible outcomes of medication errors. A 1997 study by Bates et al. (9) found that 6.5 ADEs occur for every 100 nonobstetric hospital admissions/ and that 28% of them were preventable. It also was determined that 42% of life-threatening and... 

The chart review and observation are process-based methods for detecting errors. Most of these process errors , however, do not cause harm, so these methods are not cost-effective for the study of the harmful outcomes of medication errors. 

The annual cost of medication-related errors in the United States is estimated to be over 7 billion [5,16]. 

Froedtert now plans to become a "Six Sigma Organization," which involves expanding the use of the Six Sigma methodology to encompass reduction of medical errors, promotion of patient safety, cost reduction, and enhancement of process efficiency. 

A recent report by the Inshtute of Medicine (lOM), To Err is Human, Building a Safer Health System, claims that an3rwhere from 44,000 to 98,000 people die each year as a result of preventable medical errors. Many of these adverse events are associated with the use of pharmaceuhcals and are potenhally preventable. The lOM estimates that in the United States more than 7000 deaths occur annually as a result of preventable medication errors. In addihon, preventable medicahon errors are estimated to increase hospital costs by about 2 billion nationwide. ... 

National Academies of Science, Medication Errors Injure 1.5 Million People and Cost Billions of Dollars Annually Report Offers Comprehensive Strategies for Reducing Drug-Related Mistakes, News from the National Academies. Available online. URL http //www8.nationalacademies.org/onpinews/newsitem. aspx RecordID=11623. Posted July 20, 2006. 

A panel of experts brought together to investigate prescription drug errors in hospitals reports that medication errors harm 1.5 million people each year and increase medical care costs by 3.5 billion. 

Economic outcomes Costs associated with sleep loss and fatigue (e.g., fatigue related medical errors) Cost-benefit analyses of fatigue management programs Hospital costs Patient care costs Direct and indirect costs... 

The safety of the medication system is the primary concern of every hospital pharmacist. Recently published reports of the incidence, causes, and cost of injury resulting from medication errors have led many hospitals to critically evaluate their quality assurance systems (Bates et al., 1996, 1997 Classen et al., 1997 Kohn, Corrigan, and Donaldson, 1999 Leape et al., 1991, 1995 Poon et al., 2006 Stelfox, et al., 2006). Written incident reports were once the standard for gathering information about medication misadventures. This method is now believed to lack sufficient completeness and reliability for identifying weaknesses in a medication system (Classen et al., 1991 Cullen et al., 1995 Leape, 1994, 2002 Leape et al., 1995). 

Harm attributable to drugs is a major reason for malpractice claims associated with medical proce-duresJ The average compensation for medication errors between 1985 and 1992 was almost 100,000. Most compensation for medication errors is for larger amounts that are agreed on in out-of-court settle-ments.f None of the costs cited above include the cost of patient harm or subsequent hospital admissions. ... 

The traditional system of providing patient care— wherein physicians initiate drug therapy, pharmacists dispense medications, and nurses administer medica-tion.s—is often run in a disjointed fashion. This results in potentially avoidable adverse drug events that contribute to poor patient outcomes and increased medical costs. Efforts aimed at modifying the current processes of care to enhance efficiency of workflow, improve patient outcomes, and reduce medication errors arc needed. 

---