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Large Study Identifies Most Costly Adverse Events in Children's Hospitals
Date:6/2/2008

,656, or approximately 1.5 percent of the sample. Overall, the most frequent adverse events in hospitalized children were infection due to medical care, respiratory failure following surgery and postoperative sepsis (an infection in the bloodstream).

The excess length of hospital stay from PDI events ranged from 2.8 days for accidental puncture and laceration to 23.5 days for postoperative sepsis. Excess overall charges ranged from $34,884 for accidental puncture and laceration to $337,226 for in-hospital mortality after pediatric heart surgery. Among excess charges, the largest were for laboratory, room and nursing charges. The researchers adjusted charges to reflect geographical differences in prices and wages.

"Our findings may help guide physicians and hospital administrators toward changes in practices where even modest improvements could have a high impact in patient safety and in more efficient, less costly health care," said Shah. "For instance, focusing quality improvement efforts on reducing postoperative sepsis and infection due to medical care could create large cost savings and reduction in length of hospitalization. Additional studies should focus on determining specific safety measures and practices that pediatric hospitals can implement in the most appropriate areas."

Shah added that such quality improvement programs are all the more important in light of a recent decision by the federal Centers for Medicare and Medicaid Services to begin denying payments to hospitals for patients who develop preventable complications during hospitalization.

Shah's and Kronman's co-authors were Anthony D. Slonim, M.D., Ph.D., of Carilion Clinic Children's Hospital, Roanoke, Va.; and Matthew Hall, Ph.D., of the Child Health Corporation of America, Shawnee Mission, Kans.

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-
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SOURCE The Children's Hospital of Philadelphia
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