The Cost Of Drug-Related Morbidity That Lead To Emergency Visits In A Brazilian Hospital

Abstract

and model 1 + initiating-service groups (model 3). Optimism-corrected C-statistics and root mean square error (RMSE) were used to compare model prediction accuracy. Results: The cohort consisted of 3,105 individuals; of which 38.3% had a recurrent episode, with an average cost of $3,803CAD (SD= $11,959). LCA identified two groups: high user (15.2%) and low user (84.8%), while about 51.6% of the cohort was grouped as institutionalized. Model 2 predicted time to a subsequent episode better (C-statistic = 0.94) than model 3 (C-statistic = 0.91), and model 1 (C-statistic = 0.87). Model 3 predicted cost of the subsequent episode better (RMSE= 11934.5) than model 2 (RMSE= 11999.8) and model 1 (RMSE= 12075.3). ConClusions: The findings suggest that both LCA-defined groups and initiating-service groups could be used to summarize past utilization for risk prediction modeling; the choice may depend on the outcome of interest. PRM36 NoN-DiscRetioNaRy iNPuts aRe iMPoRtaNt FactoRs iN HosPital eFFicieNcy stuDies aND Policy evaluatioNPasupathy K. , Sir M. Mayo Clinic, Rochester, MN, USA objeCtives: Hospital efficiency is the focus of several studies and increasingly, data envelopment analysis (DEA) is used to compute and compare efficiencies of hospitals for quality improvement and policy analysis. DEA is a non-parametric approach to compute efficiency considering multiple inputs and outputs and benchmark hospitals, with the presumption that the inefficient hospitals can reduce inputs and/or increase outputs to improve their efficiency. Hospitals are complex systems and have multiple non-discretionary inputs, such as type of hospital or region of location that are not under the control of administration, and hence cannot be altered. This study emphasizes the need to consider non-discretionary inputs in DEA models. Methods: One year's worth of Agency for Healthcare Research & Quality's Health Care Utilization Project data was used. Variables included full-time equivalent of registered nurses, licensed practical nurses and nurse aides as inputs and total discharges and percent of surgeries as outputs, with bed size, urban/ rural, teaching status, region and ownership as non-discretionary inputs. First a variable-returns-to-scale DEA model was run without the non-discretionary inputs. Next the model was repeated including an environmental harshness (created using regression). Results: When the efficiency scores of the 862 hospitals in the two stages were compared, 755 hospitals had increased efficiency, and mean increased more than three times from 0.11 (P< 0.000) and standard deviation doubled from 0.15. The number of efficient hospitals increased from 12 to 72. ConClusions: DEA can be a sophisticated method to measure hospital efficiency. Not accounting for non-discretionary inputs can radically alter the efficiency scores and bias study results. The first stage score has inefficiency and the effect of non-discretionary inputs. Since both mean and standard deviation increased dramatically, simple normalization cannot be used as ...

Competencies for the provision of comprehensive medication management services in an experiential learning project

“…Prompted by an emergent social need–drug-related morbidity and mortality [ 1 , 2 ]–the pharmacy profession is undergoing reform. To this end, pharmacists have been called to become competent in the provision of medication therapy management services, or more recently called comprehensive medication management (CMM) services [ 3 – 8 ].…”

Daño asociado al uso de medicamentos en hospitales chilenos: análisis de prevalencia 2010-2017

“…valparaíso, chile. 2 departamento de industrias, universidad técnica Federico santa María. valparaíso, chile.…”

“…os eventos adversos relacionados a medicamentos (EAM), y el subgrupo de estos, las reacciones adversas relacionadas a medicamentos (RAM), son a nivel mundial una causa relevante de hospitalizaciones o de extensión del tiempo de hospitalización 1,2 . Pese a esto, existe consenso en que un gran porcentaje de los efectos nocivos producidos por medicamentos pueden ser evitados, o al menos controlados, por medio de diversas políticas de uso, tanto a nivel de hospital como a nivel de política nacional de medicamentos 3 .…”