PMID- 37592294 OWN - NLM STAT- MEDLINE DCOM- 20230821 LR - 20231123 IS - 1741-7015 (Electronic) IS - 1741-7015 (Linking) VI - 21 IP - 1 DP - 2023 Aug 17 TI - Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study. PG - 312 LID - 10.1186/s12916-023-03024-0 [doi] LID - 312 AB - BACKGROUND: All health overuse implies an unnecessary risk of patients suffering adverse events (AEs). However, this hypothesis has not been corroborated by direct estimates for inappropriate hospital admission (IHA). The objectives of the study were the following: (1) to analyze the association between IHA and the development of subsequent AEs; (2) to explore the distinct clinical and economic implications of AEs subsequent IHA compared to appropriate admissions. METHODS: An observational cross-sectional study was conducted on hospitalized patients in May 2019 in a high-complexity hospital in Madrid, Spain. The Appropriateness Evaluation Protocol was used to measure IHA, and the methodologies of the Harvard Medical Practice Study and the European Point Prevalence Survey of Healthcare-associated Infections were used to detect and characterize AEs. The association between IHA and the subsequent. RESULTS: A total of 558 patients in the hospital ward were studied. IHA increased the risk of subsequent occurrence of AEs (OR [95% CI]: 3.54 [1.87 to 6.69], versus appropriate) and doubled the mean AEs per patient (coefficient [95% CI]: 0.19 [0.08 to 0.30] increase, versus appropriate) after adjusting for confounders. IHA was a predictive variable of subsequent AEs and the number of AEs per patient. AEs developed after IHA were associated with scheduled admissions (78.9% of AEs, versus 27.9% after appropriate admissions; p < 0.001). Compared with AEs developed after appropriate admissions, AEs after IHA added 2.4 additional days of stay in the intensive care unit and incurred an extra cost of euro166,324.9 for the studied sample. CONCLUSIONS: Patients with IHA have a higher risk of subsequent occurrence of AE. Due to the multifactorial nature of AEs, IHA is a possible contributing factor. AEs developed after IHA are associated with scheduled admissions, prolonged ICU stays, and resulted in significant cost overruns. CI - (c) 2023. BioMed Central Ltd., part of Springer Nature. FAU - San Jose-Saras, Diego AU - San Jose-Saras D AUID- ORCID: 0000-0002-7063-5912 AD - Preventive Medicine and Public Health Service, Hospital Universitario Ramon y Cajal, IRYCIS, 28034, Madrid, Spain. AD - Universidad de Alcala, School of Medicine and Health Sciences, Department of Medicine and Medical Specialities, Alcala de Henares, Spain. FAU - Vicente-Guijarro, Jorge AU - Vicente-Guijarro J AUID- ORCID: 0000-0001-7447-9390 AD - Preventive Medicine and Public Health Service, Hospital Universitario Ramon y Cajal. IRYCIS. CIBER of Epidemiology and Public Health (CIBERESP), 28034, Madrid, Spain. jorge.vicente@salud.madrid.org. AD - Faculty of Health Sciences, Universidad Internacional de La Rioja, 26006, Logrono, La Rioja, Spain. jorge.vicente@salud.madrid.org. FAU - Sousa, Paulo AU - Sousa P AUID- ORCID: 0000-0001-9502-6075 AD - NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal. FAU - Moreno-Nunez, Paloma AU - Moreno-Nunez P AUID- ORCID: 0000-0002-8873-8688 AD - Preventive Medicine and Public Health Service, Hospital Universitario Ramon y Cajal, IRYCIS, 28034, Madrid, Spain. AD - Faculty of Health Sciences, Universidad Internacional de La Rioja, 26006, Logrono, La Rioja, Spain. FAU - Aranaz-Andres, Jesus Maria AU - Aranaz-Andres JM AUID- ORCID: 0000-0002-3658-0321 AD - Preventive Medicine and Public Health Service, Hospital Universitario Ramon y Cajal. IRYCIS. CIBER of Epidemiology and Public Health (CIBERESP), 28034, Madrid, Spain. AD - Faculty of Health Sciences, Universidad Internacional de La Rioja, 26006, Logrono, La Rioja, Spain. CN - Health Outcomes Research Group of the Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS) LA - eng PT - Journal Article PT - Observational Study DEP - 20230817 PL - England TA - BMC Med JT - BMC medicine JID - 101190723 SB - IM MH - Humans MH - Cross-Sectional Studies MH - *Hospitalization MH - Risk Factors MH - Hospitals MH - *Cross Infection PMC - PMC10433586 OTO - NOTNLM OT - Adverse events OT - Appropriateness of health care OT - Inappropriate hospital admission OT - Patient safety COIS- The authors declare that they have no competing interests. FIR - Perez, Cristina Diaz-Agero IR - Perez CD FIR - Alfaro, Miguel Ignacio Cuchi IR - Alfaro MIC FIR - Lopez, Juan Manuel Ramos IR - Lopez JMR FIR - Haro, Mercedes Garcia IR - Haro MG FIR - Chavez, Abelardo Claudio Fernandez IR - Chavez ACF FIR - Valdes, Cornelia Bischofberger IR - Valdes CB FIR - Laso, Amaranta Mcgee IR - Laso AM FIR - Liarte, Carmen Garrote IR - Liarte CG FIR - Montero, Gerardo Gomez IR - Montero GG FIR - Cortes, Juan Daniel Miranda IR - Cortes JDM FIR - Gomez, Gema Nieto IR - Gomez GN FIR - Herrero, Jessica Alia IR - Herrero JA FIR - de la Hoz San Clemente, Sara IR - de la Hoz San Clemente S FIR - Touya, Marta Gonzalez IR - Touya MG FIR - Mambie, Moises David Espejo IR - Mambie MDE FIR - Gomez, Diana Carretero IR - Gomez DC FIR - Pareja, Manuela Serrano IR - Pareja MS FIR - Ruiz, Marco Antonio Espinel IR - Ruiz MAE FIR - Gallardo, Raquel Gutierrez IR - Gallardo RG FIR - Leon, Eva Elisa Alvarez IR - Leon EEA FIR - Gutierrez, Paloma Navas IR - Gutierrez PN FIR - Arza, Nerea Armenteros IR - Arza NA FIR - Montrull, Francisco Bolumar IR - Montrull FB FIR - de la Santa Vinuela, Ana Garcia IR - de la Santa Vinuela AG FIR - Sanz, Raquel Arguedas IR - Sanz RA FIR - Redin, Miriam Roncal IR - Redin MR EDAT- 2023/08/18 00:42 MHDA- 2023/08/21 06:42 PMCR- 2023/08/17 CRDT- 2023/08/17 23:43 PHST- 2023/05/08 00:00 [received] PHST- 2023/08/07 00:00 [accepted] PHST- 2023/08/21 06:42 [medline] PHST- 2023/08/18 00:42 [pubmed] PHST- 2023/08/17 23:43 [entrez] PHST- 2023/08/17 00:00 [pmc-release] AID - 10.1186/s12916-023-03024-0 [pii] AID - 3024 [pii] AID - 10.1186/s12916-023-03024-0 [doi] PST - epublish SO - BMC Med. 2023 Aug 17;21(1):312. doi: 10.1186/s12916-023-03024-0.