Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study
Abstract Background All health overuse implies an unnecessary risk of patients suffering adverse events (AEs). However, this hypothesis has not been corroborated by direct estimates for inappropriate hospital admission (IHA). The objectives of the study were the following: (1) to analyze the associa...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-023-03024-0 |
| _version_ | 1827634069570060288 |
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| author | Diego San Jose-Saras Jorge Vicente-Guijarro Paulo Sousa Paloma Moreno-Nunez Jesús María Aranaz-Andres Health Outcomes Research Group of the Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) |
| author_facet | Diego San Jose-Saras Jorge Vicente-Guijarro Paulo Sousa Paloma Moreno-Nunez Jesús María Aranaz-Andres Health Outcomes Research Group of the Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) |
| author_sort | Diego San Jose-Saras |
| collection | DOAJ |
| description | Abstract Background All health overuse implies an unnecessary risk of patients suffering adverse events (AEs). However, this hypothesis has not been corroborated by direct estimates for inappropriate hospital admission (IHA). The objectives of the study were the following: (1) to analyze the association between IHA and the development of subsequent AEs; (2) to explore the distinct clinical and economic implications of AEs subsequent IHA compared to appropriate admissions. Methods An observational cross-sectional study was conducted on hospitalized patients in May 2019 in a high-complexity hospital in Madrid, Spain. The Appropriateness Evaluation Protocol was used to measure IHA, and the methodologies of the Harvard Medical Practice Study and the European Point Prevalence Survey of Healthcare-associated Infections were used to detect and characterize AEs. The association between IHA and the subsequent. Results A total of 558 patients in the hospital ward were studied. IHA increased the risk of subsequent occurrence of AEs (OR [95% CI]: 3.54 [1.87 to 6.69], versus appropriate) and doubled the mean AEs per patient (coefficient [95% CI]: 0.19 [0.08 to 0.30] increase, versus appropriate) after adjusting for confounders. IHA was a predictive variable of subsequent AEs and the number of AEs per patient. AEs developed after IHA were associated with scheduled admissions (78.9% of AEs, versus 27.9% after appropriate admissions; p < 0.001). Compared with AEs developed after appropriate admissions, AEs after IHA added 2.4 additional days of stay in the intensive care unit and incurred an extra cost of €166,324.9 for the studied sample. Conclusions Patients with IHA have a higher risk of subsequent occurrence of AE. Due to the multifactorial nature of AEs, IHA is a possible contributing factor. AEs developed after IHA are associated with scheduled admissions, prolonged ICU stays, and resulted in significant cost overruns. |
| first_indexed | 2024-03-09T15:08:16Z |
| format | Article |
| id | doaj.art-d078838b3fc64d01863f6883c8c7586f |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-03-09T15:08:16Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-d078838b3fc64d01863f6883c8c7586f2023-11-26T13:33:41ZengBMCBMC Medicine1741-70152023-08-0121111310.1186/s12916-023-03024-0Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional studyDiego San Jose-Saras0Jorge Vicente-Guijarro1Paulo Sousa2Paloma Moreno-Nunez3Jesús María Aranaz-Andres4Health Outcomes Research Group of the Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS)Preventive Medicine and Public Health Service, Hospital Universitario Ramón y Cajal, IRYCISPreventive Medicine and Public Health Service, Hospital Universitario Ramón y Cajal. IRYCIS. CIBER of Epidemiology and Public Health (CIBERESP)NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University LisbonPreventive Medicine and Public Health Service, Hospital Universitario Ramón y Cajal, IRYCISPreventive Medicine and Public Health Service, Hospital Universitario Ramón y Cajal. IRYCIS. CIBER of Epidemiology and Public Health (CIBERESP)Abstract Background All health overuse implies an unnecessary risk of patients suffering adverse events (AEs). However, this hypothesis has not been corroborated by direct estimates for inappropriate hospital admission (IHA). The objectives of the study were the following: (1) to analyze the association between IHA and the development of subsequent AEs; (2) to explore the distinct clinical and economic implications of AEs subsequent IHA compared to appropriate admissions. Methods An observational cross-sectional study was conducted on hospitalized patients in May 2019 in a high-complexity hospital in Madrid, Spain. The Appropriateness Evaluation Protocol was used to measure IHA, and the methodologies of the Harvard Medical Practice Study and the European Point Prevalence Survey of Healthcare-associated Infections were used to detect and characterize AEs. The association between IHA and the subsequent. Results A total of 558 patients in the hospital ward were studied. IHA increased the risk of subsequent occurrence of AEs (OR [95% CI]: 3.54 [1.87 to 6.69], versus appropriate) and doubled the mean AEs per patient (coefficient [95% CI]: 0.19 [0.08 to 0.30] increase, versus appropriate) after adjusting for confounders. IHA was a predictive variable of subsequent AEs and the number of AEs per patient. AEs developed after IHA were associated with scheduled admissions (78.9% of AEs, versus 27.9% after appropriate admissions; p < 0.001). Compared with AEs developed after appropriate admissions, AEs after IHA added 2.4 additional days of stay in the intensive care unit and incurred an extra cost of €166,324.9 for the studied sample. Conclusions Patients with IHA have a higher risk of subsequent occurrence of AE. Due to the multifactorial nature of AEs, IHA is a possible contributing factor. AEs developed after IHA are associated with scheduled admissions, prolonged ICU stays, and resulted in significant cost overruns.https://doi.org/10.1186/s12916-023-03024-0Appropriateness of health careInappropriate hospital admissionPatient safetyAdverse events |
| spellingShingle | Diego San Jose-Saras Jorge Vicente-Guijarro Paulo Sousa Paloma Moreno-Nunez Jesús María Aranaz-Andres Health Outcomes Research Group of the Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study BMC Medicine Appropriateness of health care Inappropriate hospital admission Patient safety Adverse events |
| title | Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study |
| title_full | Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study |
| title_fullStr | Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study |
| title_full_unstemmed | Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study |
| title_short | Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study |
| title_sort | inappropriate hospital admission as a risk factor for the subsequent development of adverse events a cross sectional study |
| topic | Appropriateness of health care Inappropriate hospital admission Patient safety Adverse events |
| url | https://doi.org/10.1186/s12916-023-03024-0 |
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