Although medical injuries are recognized as a major hazard in the health
care system, little is known about their impact.
To assess excess length of stay, charges, and deaths attributable to
medical injuries during hospitalization.
Design, Setting, and Patients
The Agency for Healthcare Research and Quality (AHRQ) Patient Safety
Indicators (PSIs) were used to identify medical injuries in 7.45 million hospital
discharge abstracts from 994 acute-care hospitals across 28 states in 2000
in the AHRQ Healthcare Cost and Utilization Project Nationwide Inpatient Sample
Main Outcome Measures
Length of stay, charges, and mortality that were recorded in hospital
discharge abstracts and were attributable to medical injuries according to
Excess length of stay attributable to medical injuries ranged from 0
days for injury to a neonate to 10.89 days for postoperative sepsis, excess
charges ranged from $0 for obstetric trauma (without vaginal instrumentation)
to $57 727 for postoperative sepsis, and excess mortality ranged from
0% for obstetric trauma to 21.96% for postoperative sepsis (P<.001). Following postoperative sepsis, the second most serious
event was postoperative wound dehiscence, with 9.42 extra days in the hospital,
$40 323 in excess charges, and 9.63% attributable mortality. Infection
due to medical care was associated with 9.58 extra days, $38 656 in excess
charges, and 4.31% attributable mortality.
Some injuries incurred during hospitalization pose a significant threat
to patients and costs to society, but the impact of such injury is highly