How often are potential patient safety events present on admission?

Robert L. Houchens, Anne Elixhauser, Patrick S Romano

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Background: Data fields that capture whether diagnoses are present on admission (POA)-distinguishing comorbidities from potential in-hospital complications - became part of the Uniform Bill for hospital claims in 2007. The AHRQ Patient Safety Indicators (PSIs) were initially developed as measures of potential patient safety problems that use routine administrative data without POA information. The impact of adding PQA information to PSIs was examined. Methods: Data were used from California (CA) and New York (NY) Healthcare Cost and Utilization Project (HCUP) state inpatient databases for 2003, which include POA codes. Analysis was limited to 13 of 20 PSIs for which POA information was relevant, such as complications of anesthesia, accidental puncture, and sepsis. Results: In New York, 17% of cases revealed suspect POA coding, compared with 1%-2% in California. After suspect records were excluded, 92%-93% of secondary diagnoses in both CA and NY were POA. After incorporating POA information, most cases of decubitus ulcer (86%-89%), postoperative hip fracture (74%-79%), and postoperative pulmonary embolism/deep vein thrombosis (54%-58%) were no longer considered in-hospital patient safety events. Discussion: Three of 13 PSIs appear not to be valid measures of in-hospital patient safety events, but the remaining 10 appear to be potentially useful measures even in the absence of POA codes.

Original languageEnglish (US)
Pages (from-to)154-163
Number of pages10
JournalJoint Commission Journal on Quality and Patient Safety
Volume34
Issue number3
StatePublished - Mar 2008

Fingerprint

Patient Safety
Pressure Ulcer
Hip Fractures
Pulmonary Embolism
Punctures
Venous Thrombosis
Health Care Costs
Comorbidity
Inpatients
Sepsis
Anesthesia
Databases

ASJC Scopus subject areas

  • Leadership and Management

Cite this

How often are potential patient safety events present on admission? / Houchens, Robert L.; Elixhauser, Anne; Romano, Patrick S.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 34, No. 3, 03.2008, p. 154-163.

Research output: Contribution to journalArticle

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