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dc.contributor.authorJackson, Terri
dc.contributor.authorNghiem, Hong Son
dc.contributor.authorRowell, David
dc.contributor.authorJorm, Christine
dc.contributor.authorWakefield, John
dc.date.accessioned2018-04-13T01:30:23Z
dc.date.available2018-04-13T01:30:23Z
dc.date.issued2011
dc.date.modified2013-04-29T02:01:17Z
dc.identifier.issn1355-8196
dc.identifier.doi10.1258/jhsrp.2010.010050
dc.identifier.urihttp://hdl.handle.net/10072/49412
dc.description.abstractMethods Patient level costs were estimated using computerized costing systems that log individual utilization of inpatient services and apply sophisticated cost estimates from the hospital's general ledger. Occurrence of hospital-acquired conditions was identified using an Australian 'condition-onset' flag for diagnoses not present on admission. These were grouped to yield a comprehensive set of 144 categories of hospital-acquired conditions to summarize data coded with ICD-10. Standard linear regression techniques were used to identify the independent contribution of hospital-acquired conditions to costs, taking into account the case-mix of a sample of acute inpatients (n = 1,699,997) treated in Australian public hospitals in Victoria (2005/06) and Queensland (2006/07). Results The most costly types of complications were post-procedure endocrine/metabolic disorders, adding AU$21,827 to the cost of an episode, followed by MRSA (AU$19,881) and enterocolitis due to Clostridium difficile (AU$19,743). Aggregate costs to the system, however, were highest for septicaemia (AU$41.4 million), complications of cardiac and vascular implants other than septicaemia (AU$28.7 million), acute lower respiratory infections, including influenza and pneumonia (AU$27.8 million) and UTI (AU$24.7 million). Hospital-acquired complications are estimated to add 17.3% to treatment costs in this sample. Conclusions Patient safety efforts frequently focus on dramatic but rare complications with very serious patient harm. Previous studies of the costs of adverse events have provided information on 'indicators' of safety problems rather than the full range of hospital-acquired conditions. Adding a cost dimension to priority-setting could result in changes to the focus of patient safety programmes and research. Financial information should be combined with information on patient outcomes to allow for cost-utility evaluation of future interventions.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.format.extent373409 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglish
dc.language.isoen_US
dc.publisherSage Publications
dc.publisher.placeUnited Kingdom
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom141
dc.relation.ispartofpageto146
dc.relation.ispartofissue3
dc.relation.ispartofjournalJournal of Health Services Research & Policy
dc.relation.ispartofvolume16
dc.rights.retentionY
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classified
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchApplied Economics
dc.subject.fieldofresearchcode119999
dc.subject.fieldofresearchcode1117
dc.subject.fieldofresearchcode1402
dc.titleMarginal costs of hospital-acquired conditions: information for priority-setting for patient safety programmes and research
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.rights.copyright© 2011 RSM Press. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal website for access to the definitive, published version.
gro.date.issued2011
gro.hasfulltextFull Text
gro.griffith.authorRowell, David
gro.griffith.authorNghiem, Son H.


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