scholarly journals The Burden of Preventable Adverse Drug Events on Hospital Stay and Healthcare Costs in Japanese Pediatric Inpatients: The JADE Study

2021 ◽  
Vol 15 ◽  
pp. 117955652199583
Author(s):  
Hitoshi Iwasaki ◽  
Mio Sakuma ◽  
Hiroyuki Ida ◽  
Takeshi Morimoto
Keyword(s):  
Hospital Stay ◽  
Medication Errors ◽  
Healthcare Costs ◽  
Pediatric Patients ◽  
Adverse Drug Events ◽  
Length Of Hospital Stay ◽  
Sensitivity Analyses ◽  
National Burden ◽  
The Individual ◽  
Preventable Ades

Background: Adverse drug events (ADEs) are a burden to the healthcare system. Preventable ADEs, which was ADEs due to medication errors, could be reduced if medication errors can be prevent or ameliorate. Objective: We investigated the burden of preventable ADEs on the length of hospital stay (LOS) and costs, and estimated the national burden of preventable ADEs in pediatric inpatients in Japan. Methods: We analyzed data from the Japan Adverse Drug Events (JADE) study on pediatric patients and estimated the incidence of preventable ADEs and associated extended LOS. Costs attributable to extended LOS by preventable ADEs were calculated using a national statistics database and we calculated the effect of preventable ADEs on national cost excess. Results: We included 907 patients with 7377 patient-days. Among them, 31 patients (3.4%) experienced preventable ADEs during hospitalization. Preventable ADEs significantly increased the LOS by 14.1 days, adjusting for gender, age, ward, resident physician, surgery during hospitalization, cancer, and severe malformation at birth. The individual cost due to the extended LOS of 14.1 days was estimated as USD 8258. We calculated the annual extra expense for preventable ADEs in Japan as USD 329 676 760. Sensitivity analyses, considering the incidence of preventable ADEs and the length of hospital stay, showed that the expected range of annual extra expense for preventable ADEs in Japan is between USD 141 468 968 and 588 450 708. Conclusion: Preventable ADEs caused longer hospitalization and considerable extra healthcare costs in pediatric inpatients. Our results would encourage further efforts to prevent and ameliorate preventable ADEs.

Differences in adverse drug events and medication errors among pediatric inpatients aged <3 and ≥3 years: The JADE study

2021 ◽  
pp. 251604352110467
Author(s):  
Jiro Takeuchi ◽  
Mio Sakuma ◽  
Yoshinori Ohta ◽  
Hiroyuki Ida ◽  
Takeshi Morimoto
Keyword(s):  
Hospital Stay ◽  
Medication Errors ◽  
Primary Outcome ◽  
Pediatric Patients ◽  
Adverse Drug Events ◽  
Medication Use ◽  
Skill Levels ◽  
Linguistic Skills ◽  
Events Study

Background Adverse drug events (ADEs) are defined as any injuries due to medication use. We hypothesized that the incidences of ADEs and medication errors (MEs) could be associated with linguistic skills of pediatric patients. Methods We analyzed data from the Japan Adverse Drug Events study on pediatric inpatients. This study included inpatients aged one months and older and less than seven years old. We compared the primary outcome of ADEs and MEs between patients aged under three years and three years and older as children typically do not acquire sufficient linguistic skills until around three years of age. Results This study included 639 patients; 412 (64%) patients aged under three years and 227 (36%) patients aged three years and older. We identified 241 ADEs in 639 patients; 152 ADEs among patients aged under three years (37 ADEs per 100 patients) and 89 ADEs among those aged three years and older (39 ADEs per 100 patients). ADEs among patients aged under three years were less likely to be found (49 ADEs) during their hospital stay than those aged three years and older (20 ADEs) ( P = 0.02). Among 172 MEs identified in 639 patients, 25 MEs (15%) resulted in ADEs; 23 (92%) occurred to those aged under three years and two (8%) occurred to those aged three years and older ( P = 0.0008). Conclusion ADEs were less likely to be found and MEs resulted in ADEs more frequently in patients under three years old, and these differences could be explained by differences in their linguistic skill levels.

scholarly journals Robotic adrenalectomy in the pediatric population: initial experience case series from a tertiary center

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anirban P. Mitra ◽  
Evalynn Vasquez ◽  
Paul Kokorowski ◽  
Andy Y. Chang
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Operating Time ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Open Approach ◽  
Invasive Approach ◽  
Patients Âgés ◽  
Tertiary Center

Abstract Background Laparoscopic resection is the most well described minimally-invasive approach for adrenalectomy. While it allows for improved cosmesis, faster recovery and decreased length of hospital stay compared with the open approach, instrument articulation limitations can hamper surgical dexterity in pediatric patients. Use of robotic assistance can greatly enhance operative field visualization and instrument control, and is in the early stages of adoption in academic centers for pediatric populations. Case presentation We present a single-institution series of pediatric adrenalectomy cases. The da Vinci Xi surgical system was used to perform adrenalectomies on three consecutive patients (ages, 2–13 years) at our center. Final pathology revealed ganglioneuroblastoma (n = 2) and pheochromocytoma (n = 1). Median operating time was 244 min (range, 244–265 min); median blood loss was estimated at 100 ml (range, 15–175 ml). Specimens were delivered intact and all margins were negative. Median post-operative hospital stay was 2 days (range, 1–6 days). All patients remain disease-free at median follow-up of 19 months (range, 12–30 months). Conclusion Our experience continues to evolve, and suggests that robotic surgery is safe, feasible and oncologically effective for resection of adrenal masses in well-selected pediatric patients.

The Effect of Anticipatory Discharge Orders on Length of Hospital Stay in Staff Pediatric Patients

1997 ◽  
Vol 12 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Timur Sumer ◽  
D. Kay Taylor ◽  
Marney McDonald ◽  
Vicki McKinney ◽  
Margaret Gillard ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Length Of Hospital Stay

scholarly journals Accuracy of triggers in the identification of adverse drug events in hospitalized elderly

2020 ◽  
Vol 9 (12) ◽  
pp. e33491211135
Author(s):  
Chriscia Jamilly Pinto de Sousa ◽  
Ana Cristina Lo Prete ◽  
Carolina Heitmann Mares Azevedo Ribeiro
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Adverse Drug Events ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Individual Performance ◽  
Hospitalized Elderly ◽  
Naranjo Algorithm ◽  
Global Trigger Tool ◽  
The Individual

Objective: Evaluate trigger accuracy for identifying adverse drug events (ADEs) in hospitalised elderly. Methods: Two hundred patients 60 years old from a medical clinic within a private hospital were followed-up. For ADE identification the adapted Global Trigger Tool tracker methodology was used. Causality was determined using the Naranjo Algorithm. Results: Of the 200 elderly patients included in the study, 106 were females (53%), the average age was 79 years, and the average length of hospital stay was approximately ± 10 days. Selected triggers were identified 1,457 times. The group of triggers with the best performance regarding its analysis accuracy was evolution triggers, with sensitivity of 69% and positive predictive value of 68%. In the individual performance analysis, the evolution tracker allergy, allergic reaction, pruritus achieved 100% performance for both sensitivity and positive predictive value. A total of 165 ADs were identified. Of these, 18% were phlebitis and 16% were hypoglycaemia. Drugs associated with ADE included insulin (15%) and Clarithromycin (9%). Conclusion: The triggering methodology has been effective for identifying ADEs. In addition, determination best trigger for constructing an ADE identification tool for hospitalised elderly was performed.

scholarly journals Assessment of healthcare costs of amputation and prosthesis for upper and lower extremities in a Qatari healthcare institution: a retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024963 ◽  
Author(s):  
Hassan Al-Thani ◽  
Brijesh Sathian ◽  
Ayman El-Menyar
Keyword(s):  
Diabetes Mellitus ◽  
Hospital Stay ◽  
Healthcare Cost ◽  
Healthcare Costs ◽  
Retrospective Cohort ◽  
Length Of Hospital Stay ◽  
Lower Extremities ◽  
Total Cost ◽  
Upper And Lower Extremities ◽  
Bed Days

ObjectivesTo evaluate the healthcare cost of amputation and prosthesis for management of upper and lower extremities in a single institute.DesignRetrospective cohort study conducted between 2000 and 2014.ParticipantsAll patients who underwent upper (UEA) and lower extremities amputation (LEA) were identified retrospectively from the operating theatre database. Collected data included patient demographics, comorbidities, interventions, costs of amputations including hospitalisation expenses, length of hospital stay and mortality.Outcome measuresIncidence, costs of amputation and hospitalisation according to the level of the amputation and cost per bed days, length of hospital stay and mortality.ResultsA total of 871 patients underwent 1102 (major 357 and minor 745) UEA and LEA. The mean age of patients was 59.4±18.3, and 77.2% were males. Amputations were most frequent among elderly (51.1%). Two-third of patients (75.86%, 95% CI 72.91% to 78.59%) had diabetes mellitus. Females, Qatari nationals and non-diabetics were more likely to have higher mean amputation and hospital stay cost. The estimated total cost for major and minor amputations were US$3 797 930 and US$2 344 439, respectively. The cumulative direct healthcare cost comprised total cost of all amputations, bed days cost and prosthesis cost and was estimated to be US$52 126 496 and per patient direct healthcare procedure cost was found to be US$59 847. The total direct related therapeutic cost was estimated to be US$26 096 046 with per patient cost of US$29 961. Overall per patient cost for amputation was US$89 808.ConclusionsThe economic burden associated with UEA and LEA-related hospitalisations is considerable. Diabetes mellitus, advanced age and sociodemographic factors influence the incidence of amputation and its associated healthcare cost. The findings will help to showcase the economic burden of amputation for better management strategies to reduce healthcare costs. Furthermore, larger prospective studies focused on cost-effectiveness of primary prevention strategies to minimise diabetic complication are warranted.

The type and incidence of adverse drug events in ageing medical inpatients and their effect on length of hospital stay

2017 ◽  
Vol 47 (5) ◽  
pp. 347-354 ◽  
Author(s):  
Chariclia Paradissis ◽  
Ian D. Coombes ◽  
Peter Donovan ◽  
Elizabeth Doran ◽  
Mitchell McKean ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Adverse Drug Events ◽  
Length Of Hospital Stay ◽  
Medical Inpatients

scholarly journals A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1241
Author(s):  
Silvia Zanato ◽  
Marina Miscioscia ◽  
Annalisa Traverso ◽  
Miriam Gatto ◽  
Mikael Poli ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Psychiatric Symptoms ◽  
Length Of Hospital Stay ◽  
Discharge Diagnosis ◽  
Psychiatric Hospitalizations ◽  
Hospital Stays ◽  
Potential Factors

The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. Methods: 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. Results: Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. Conclusions: These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments.

scholarly journals The clinical application of kangaroo mother care in neonates after surgery for duodenal obstruction

2021 ◽  
Author(s):  
Li-Bo Zhu ◽  
Yan-Hua Xu ◽  
Jin-Fen Li ◽  
Xue Hu ◽  
Chun-Yan Lu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Application ◽  
Duodenal Obstruction ◽  
Pediatric Patients ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Kangaroo Mother Care ◽  
Conventional Care ◽  
Control Group ◽  
Observation Group

Abstract Background: The present study aimed to explore the effectiveness of clinical application of kangaroo mother care (KMC) in neonates after surgery for duodenal obstruction in achieving total enteral nutrition (TEN) and shortening the length of hospital stay.Methods: A prospective study of 60 cases of surgery for duodenal obstruction in pediatric patients in the neonatal intensive care unit of Kunming Children's Hospital between January 2018 and December 2019 was conducted. The study subjects included 15 cases with intestinal malrotation, 18 cases with circular pancreas, 10 cases with a duodenal septum, and 17 cases with duodenal atresia or duodenal stenosis. According to the single and double numbers of the operation date, the subjects were randomly divided into the control group and observation group, with 30 cases in each group. The conventional care of enhanced recovery after surgery (ERAS) was carried out in the control group, and KMC based on ERAS conventional care was implemented in the observation group. The difference in the duration to achieve TEN and the length of hospital stay between the two groups of patients after care was compared and analyzed.Results: The average duration to achieve TEN for neonates with duodenal obstruction in the control group was 14.23 ± 3.17 days, while that in the observation group was 12.27 ± 1.15 days. The average length of hospital stay in the control group was 17.22 ± 4.71 days, while that in the observation group was 13.34 ± 2.70 days. There was a significant difference in the duration to achieve TEN and the average length of hospital stay between the two groups (P < 0.05). The duration to achieve TEN and the length of hospital stay in pediatric patients were significantly shorter in the observation group than in the control group.Conclusions: KMC has important clinical significance and application value in shortening the duration to achieve TEN and the length of hospital stay in neonates after surgery for duodenal obstruction.

scholarly journals A Multidisciplinary Study of the Use and Outcomes Associated with Expanded Respiratory Viral Studies at a Mid-Sized Children’s Hospital

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S354-S354
Author(s):  
Chelsea Zhu ◽  
Sabeen Sidiki ◽  
Brittany Grider ◽  
Brian Fink ◽  
Nicole Hubbard ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Length Of Hospital Stay ◽  
Antibiotic Use ◽  
Respiratory Pathogen ◽  
Hospital Inpatient ◽  
Pediatric Hospital ◽  
Children's Hospital ◽  
Days Of Therapy ◽  
Children’S Hospital

Abstract Background Acute respiratory infection (ARI) is a leading cause of pediatric hospitalizations in the US and are generally caused by viruses, thus antibiotics are prescribed more often than needed. Identifying viral agents using the respiratory pathogen panel (RPP) can help with judicious use of antibiotics in hospitalized patients. ProMedica Toledo Children’s Hospital, a mid-sized pediatric hospital, began offering the RPP to patients in Dec 2014. This study was conducted to assess if the use of RPP would decrease the antibiotic days of therapy (DOT) and length of hospital stay for patients admitted for uncomplicated ARI and for those seen in the ED. Methods This was a retrospective analysis of pediatric hospital inpatient and ED data collected between December 16, 2013 and December 15, 2015. Patients before and after implementation of the RPP were compared. 299 and 263 pediatric patients between 1 month to 18 years of age with uncomplicated ARIs in the pre-RPP and post-RPP periods, respectively, were included for analysis. Similarly, 472 and 461 patients were included from the ED. Clinical data were collected by chart review. Analysis was performed using descriptive and inferential statistics. Results Out of 299 admitted patients in the post-RPP period, 63 (21.1%) patients did not receive the RPP (RPP-NT). 201 (67.2%) received it and tested positive (RPP-P), and 35 (11.7%) patients tested negative (RPP-N). RPP-N had an increased length of hospital stay (P = 0.055, borderline significance) and increased number of antibiotic DOT (P = 0.032) than RPP-P. Furthermore, we discovered that older patients (mean = 6.21 years) tested negative with RPP, while younger patients either did not receive the test (mean = 2.43 years) or tested positive (mean = 2.40 years). In the ED, RPP-P received fewer discharge prescriptions for antibiotics than RPP-N and RPP-NT (P &lt; 0.01). The use of RPP was more prevalent in admitted patients than in ED patients (P = 0.01). Conclusion Our results suggest that the use of RPP effectively curbs unnecessary antibiotic use for pediatric patients with viral ARIs. Furthermore, age discrepancies among RPP-P, RPP-N, and RPP-NT warrant further study. Lastly, the results suggest that use of RPP in ED should be encouraged. Disclosures C. Zhu, IDSA Foundations Medical Scholars Program 2015–2016: Member, Educational scholarship.

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