Conditions picked up by hospital patients estimated to cost health system €91m a year

Conditions picked up by hospital patients estimated to cost health system €91m a year

The majority of patients were admitted as emergency cases and over a third in the sample were classified as having health issues of major complexity, although more than half had minor issues. File photo: PA

Avoidable illnesses affecting people after they enter hospitals could be costing the health system €91.3m a year, according to the first such study of its kind in Ireland.

Researchers used data sourced from 5,544 patient discharge records from six acute wards within three hospitals across a 16-month period. They found that 16% of the sample had at least one nurse-sensitive adverse event during their episode of care.

Nurse-sensitive adverse events are those that occur in health care as a result of errors of commission or omission. They are seen as preventable. A total of 11 outcomes sensitive to nurse staffing were identified in the In‐Patient Enquiry (HIPE) system, including pressure ulcers, hospital‐acquired pneumonia, and wound infection.

The majority of patients were admitted as emergency cases and over a third in the sample were classified as having health issues of major complexity, although more than half had minor issues.

Of those who experienced a nurse-sensitive adverse event, 76% had one event but 20% had two events and 4% had three or more. Those affected had an average age of 71.8 years.

The study worked out the extra cost associated with these incidents, particularly in terms of adding to the length of stay in the hospital, and estimated the economic impact associated with each nurse-sensitive outcome to be €694.

For the study sample that resulted in a total cost of €800,000, and the researchers said: "Extrapolating this nationally, the economic cost of nurse sensitive adverse events to the health service in Ireland is estimated to be €91.3 million annually. These potentially avoidable events are associated with a significant economic burden to health systems."

The published study, entitled Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings, was carried out by researchers from the Cork University Business School at University College Cork, NUI Galway, the University of Southampton, the University of Technology in Sydney and the School of Nursing and Midwifery in UCC. The data period ran from July 2016 to October 2017.

Prof. Jonathan Drennan, Professor of Nursing and Health Services Research at UCC, said the study findings were part of a larger project that is already informing how medical cover is provided.

The research is supported by the Health Research Board and the Department of Health and Prof. Drennan said data findings from medical surgical wards had already informed staffing levels there, and now similar work on Emergency Departments is being analysed before being provided to the Department to assist any potential changes to staffing levels in that sector.

Prof. Drennan said just because an event of illness was avoidable did not mean it was always preventable and he also said that it was not simply a case of providing more nurses, but that it could be a case of targeting resources in a specific way, based on patient profile at triage.

"It's not always more nurses - it's the appropriate number at the appropriate time," he said.

A pilot project is taking data from Cork University Hospital, Tipperary General Hospital and the Mater Hospital, with results expected later in the year.

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