Adverse Events Experienced by Patients Hospitalized without Definite Medical Acuity: A Retrospective Cohort Study

J Hosp Med. 2020 Jan 1;15(1):42-45. doi: 10.12788/jhm.3235. Epub 2019 Jun 19.

Abstract

Physicians often consider various nonmedical factors in hospital admission decision-making and may admit socially tenuous patients despite low-acuity medical needs. Evidence showing whether these patients are subject to the same risks of hospitalization as those considered definitely medically appropriate is limited. Our study sought to inform this risk/benefit discussion by quantifying the number of adverse events (AEs) experienced by both patient populations by using the Institute for Healthcare Improvement Global Trigger Tool methodology. We found no difference in the percentage of admissions with AEs between the two groups (27.3% vs 29.3%; risk ratio 0.93, 95% CI 0.65-1.34, P = .70) nor in AEs per 1,000-patient days (76.8 vs 70.4; incidence rate ratio = 1.09, 95% CI 0.77-1.55, P = .61). Thus, the number of AEs experienced during hospitalization does not appear to be related to the appropriateness of admission based on the level of medical acuity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Length of Stay*
  • Male
  • Medical Records
  • Middle Aged
  • Patient Safety*
  • Quality Indicators, Health Care*
  • Retrospective Studies
  • Severity of Illness Index*