Implementing technologies to prevent medication errors at a high-complexity hospital: analysis of cost and results

Vilela, Renata Prado Bereta; Jericó, Marli de Carvalho

doi:10.31744/einstein_journal/2019GS4621

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Sumário

Health Economics and Management • EINSEinstein (São Paulo) 17 (4) • 2019 • https://doi.org/10.31744/einstein_journal/2019GS4621 copy

Implementing technologies to prevent medication errors at a high-complexity hospital: analysis of cost and results

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To calculate the cost and assess the results on implementing technological resources that can prevent medication errors.

Methods:

A retrospective, descriptive-exploratory, quantitative study (2007-2015), in the model of case study at a hospital in the Brazilian Southeastern Region. The direct cost of each technology was calculated in the drug chain. Technological efficacy was observed from the reported series of the indicator incidence of medication errors.

Results:

Thirteen technologies were identified to prevent medication errors. The average cost of these technologies per year in the prescription stage was R$ 3.251.757,00; in dispensing, R$ 2.979.397,10; and in administration, R$ 4.028.351,00. The indicator of medication error incidence decreased by 97.5%, gradually between 2007 to 2015, ranging from 2.4% to 0.06%.

Conclusion:

The average cost per year of the organization to implement preventive technologies in the drug chain totaled up R$ 10.259.505,10. There was an average investment/year of R$ 55,72 per patient and its association with smaller indicator of incidence of medication errors confirms a satisfactory result in this reported series regarding such investment.

Keywords:
Patient safety; Medication errors; Medication systems, hospital; Technology; Accident prevention; Costs and cost analysis

Medication Flow	Implementation	Classification	Technology	Cost of labor		Cost of material/equipment		Total cost
Medication Flow	Implementation	Classification	Technology	2014	2015	2014	2015	2014	2015
Administration	2011	Soft	Trainings	0.37	0.40	0.00	0.00	0.37	0.40
Administration	2011	Soft	Orientation	0.68	0.73	0.00	0.00	0.68	0.73
Administration	–	Hard	Infusion pump	1.08	1.31	12.23	15.23	13.31	16.54
Administration	2014	Soft-hard	Double checking	1.33	1.43	0.00	0.00	1.33	1.43
Administration	2012	Hard	Identification of routes	0.96	1.04	0.00	0.00	0.96	1.04
Administration	2013	Hard	Identification plates	2.52	3.98	0.20	0.28	2.72	4.26
Prescription and administration	2011	Hard	Identification bracelets	0.51	0.56	0.78	0.86	1.29	1.42
Dispensing and administration	2010	Hard	Electronic dispensing	1.95	2.13	3.63	3.52	5.58	5.65
Dispensing and administration	2013	Hard	Unit packages	0.49	0.50	1.83	2.09	2.32	2.59
Dispensing and administration	2013	Hard	Kits	7.45	7.43	0.53	0.46	7.98	7.89
Dispensing and administration	2012	Hard	Label for HRM	0.01	0.01	0.05	0.05	0.06	0.06
Dispensing and administration	2014	Hard	Bag for HRM	0.04	0.04	0.07	0.07	0.11	0.11
Prescription, dispensing and administration	2010	Hard	Electronic prescription	12.88	13.95	2.97	2.81	15.85	16.76
Total				30.27	33.51	22.29	25.37	52.56	58.88

Stage of medication flow	Cost of labor		Cost of material		Total cost		Annual projection
Stage of medication flow	R$	%	R$	%	R$	%	R$	%
Prescription	13,96	43.7	3,71	15.6	17,67	31.7	3.251.757,00	31.7
Dispensing	10,03	31.5	6,16	25.8	16,19	29.0	2.979.397,10	29.0
Administration	7,92	24.8	13,97	58.6	21,89	39.3	4.028.351,00	39.3
Total	31,91	100.0	23,84	100.0	55,75	100.0	10.259.505,10	100.0

Year	Indicator %	Cost per patient (R$)	Annual projection (R$)	Cost of error/avoidable/year (R$)
2007	2.4	14,93	2.747.523,10	5.984.160,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2008	2.3	–	–	4.957.400,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2009	2.1	–	–	6.541.360,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2010	1.5	21,93	4.035.712,10	4.873.120,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2011	0.9	2,31	425.102,37	4.663.120,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2012	0.5	1,01	185.867,27	5.250.280,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2013	0.29	13,89	2.556.135,00	5.720.120,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2014	0.08	1,49	274.200,23	6.557.600,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
2015	0.06	–	–	7.435.680,00⁽¹⁰10. Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al. The costs of adverse drugs events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277(4):307-11.⁾
Total	1.1	55,56	10.224.540,07	47.319.720,00

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[1] Corresponding author: Renata Prado Bereta Vilela, Avenida Anísio Haddad, 6,751 – Jardim Francisco Fernandes – Zip code: 15090-305 São José do Rio Preto, SP, Brazil Phone: (55 17) 3201-8200 E-mail: renata_bereta@hotmail.com