Effect of illness severity and comorbidity on patient safety and adverse events

James M Naessens, Claudia R. Campbell, Nilay D Shah, Bjorn Berg, John J. Lefante, Arthur R. Williams, Richard Culbertson

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

The objective was to investigate the effect of admission health status on hospital adverse events and added costs. Secondary data were from merged administrative and clinical sources for Mayo Clinic Rochester, Minnesota hospital discharges in 2005 (N = 60 599). This was a retrospective cross-sectional study of the effect of demographics, diagnosis group, comorbidity, and admission illness severity on adverse events, incremental costs, and length of stay (LOS) using the Agency for Healthcare Research and Quality Patient Safety Indicators and provider-reported events with harm. Estimates are derived from generalized linear models. Admission severity increased the likelihood of all types of adverse events (7.2% per unit acute physiology score for any event); 7 specific comorbidities were associated with increased events and 2 with decreased events. High admission severity increased incremental costs and LOS. Selected comorbidities increased incremental LOS but had no significant effect on incremental costs. Adverse event reporting should incorporate comorbidity and admission severity. Reimbursement incentives to improve patient safety should consider adjustment for admission health status.

Original languageEnglish (US)
Pages (from-to)48-57
Number of pages10
JournalAmerican Journal of Medical Quality
Volume27
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Patient Safety
Comorbidity
Costs and Cost Analysis
Length of Stay
Health Status
Incentive Reimbursement
Health Services Research
Linear Models
Cross-Sectional Studies
Demography

Keywords

  • adverse events
  • comorbidities
  • patient safety
  • severity of illness

ASJC Scopus subject areas

  • Health Policy

Cite this

Effect of illness severity and comorbidity on patient safety and adverse events. / Naessens, James M; Campbell, Claudia R.; Shah, Nilay D; Berg, Bjorn; Lefante, John J.; Williams, Arthur R.; Culbertson, Richard.

In: American Journal of Medical Quality, Vol. 27, No. 1, 01.2012, p. 48-57.

Research output: Contribution to journalArticle

Naessens, James M ; Campbell, Claudia R. ; Shah, Nilay D ; Berg, Bjorn ; Lefante, John J. ; Williams, Arthur R. ; Culbertson, Richard. / Effect of illness severity and comorbidity on patient safety and adverse events. In: American Journal of Medical Quality. 2012 ; Vol. 27, No. 1. pp. 48-57.
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