The Organizational Costs of Preventable Medical Errors

William B. Weeks MD, MBA, Julia Waldron RN, MS, Tina Foster MD, MPH, Peter D. Mills PhD, Erik Stalhandske MPP, MHSA (Program Manager)
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引用次数: 29

Abstract

Background

Preventable medical errors are associated with additional costs that tend to be borne by patients, but little is known about organizational costs associated with such errors. Two composite case studies (a fall and a delay in diagnosis) were used to identify the organizational costs of preventable medical errors.

Analysis

Legal, marketing, and organizational costs—direct, indirect, and long term—were associated with each of the preventable medical errors. A model was generated to examine the theoretical relationship between the costs and four determinants of corporate performance—price, wages, cost of capital, and efficiency.

Discussion

Organizations may also have a financial incentive to improve patient safety, for beyond patient and societal costs, preventable medical errors appear to account for significant legal, marketing, and operational costs for the organizations that deliver health care. Some of these costs are not so much the cost of the error but the costs of organizational responses to the error. Three broad areas of inquiry could be used to test the model and improve our understanding of the organizational costs of errors: market response to patient safety interventions, before/after studies of interventions, and case-control studies.

Summary and conclusion

Health care leaders have a moral imperative to implement systems that reduce medical errors and improve patient safety. An understanding of the costs associated with medical errors may help leaders understand the importance of patient safety from a financial perspective, develop measures to evaluate the impact of patient safety initiatives, and efficiently allocate resources to address this important health concern.

可预防医疗差错的组织成本
背景:可预防的医疗差错往往与患者承担的额外费用相关,但对与此类差错相关的组织成本知之甚少。使用两个复合案例研究(跌倒和诊断延误)来确定可预防的医疗差错的组织成本。分析法律、市场营销和组织成本——直接的、间接的和长期的——与每一个可预防的医疗差错都有关联。我们建立了一个模型来检验成本与企业绩效的四个决定因素之间的理论关系——价格、工资、资本成本和效率。组织也可能有财政动机来提高患者安全,因为除了患者和社会成本之外,可预防的医疗错误似乎占了提供医疗保健的组织的重要法律,营销和运营成本。其中一些成本与其说是错误的成本,不如说是组织对错误的反应成本。可以使用三个广泛的调查领域来测试该模型并提高我们对错误的组织成本的理解:市场对患者安全干预措施的反应,干预措施之前/之后的研究,以及病例对照研究。卫生保健领导者在道德上有责任实施减少医疗差错和提高患者安全的系统。了解与医疗差错相关的成本可以帮助领导者从财务角度理解患者安全的重要性,制定措施来评估患者安全举措的影响,并有效地分配资源来解决这一重要的健康问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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