The number of people treated in U.S. hospitals for illnesses and injuries from taking medicines jumped 52 percent between 2004 and 2008—from 1.2 million to 1.9 million—according to an April 13 News and Numbers [Health Care: AHRQ News and Numbers] from AHRQ. These medication side effects and injuries resulted from taking or being given the wrong medicine or dosage. The top five categories of medicines that together sent more than 838,000 people to emergency departments for treatment and release were: unspecified medicines (261,600); pain killers (118,100), antibiotics (95,100), tranquilizers and antidepressants (79,300), and corticosteroids and other hormones (71,400). More than half (53 percent) of hospitalized patients treated for side effects or other medication-related injuries were age 65 or older, 30 percent were 45 to 64, 14 percent were between 18 and 44, and 3 percent were under age 18. This News and Numbers finding is based on data in Medication-related Adverse Outcomes in U.S. Hospitals and Emergency Departments, 2008.
April 2011
Medication-Related Adverse Outcomes in U.S. Hospitals and Emergency Departments, 2008
Jennifer Lucado, M.P.H., Kathryn Paez, Ph.D., M.B.A., R.N., and Anne Elixhauser, Ph.D.
Introduction
The use of pharmaceuticals is an essential element of the American health care system, helping to treat acute illnesses and maintain control of chronic conditions in many people. However, medication use can result in morbidity and mortality from many types of adverse outcomes. Adverse outcomes can include side effects of prescribed drugs that are taken as directed, unintentional overdosing by the patient, and medication errors such as incorrect prescribing and dosing. The rates of medication-related adverse outcomes are increasing over time-a trend likely to continue with the aging of the population, the growth in the number of comorbidities, and polypharmacy.1,2,3,4
This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) on medication- or drug-related adverse outcomes that were seen in hospitals in 2008, updating previously published information on inpatient stays in 2004.5 In addition, we provide information on these occurrences in treat-and-release emergency department (ED) visits.
The following types of medication-related adverse outcomes are coded in these hospital and ED data:
- "drug poisoning (overdose or wrong drug given or taken in error) or accidental poisoning (accidental overdose of drug, wrong drug given or taken in error, drug taken inadvertently, and accidents in the use of drugs in medical or surgical procedures);
-- drugs causing adverse effects in therapeutic use (correct drug properly administered in therapeutic or prophylactic dosage as the cause of any adverse effect)."6
These adverse outcomes encompass adverse drug reactions ("harm caused by a drug at normal doses"), adverse drug events ("harm caused by use of a drug"), and medication errors ("inappropriate use of a drug").7 Although this analysis uses data from the hospital and ED settings, the adverse outcomes could have originated in other settings. Care was taken to exclude stays and visits associated with illicit drug use or with evidence of intentional harm, self-inflicted or otherwise. All differences between estimates noted in the text are statistically significant at the 0.05 level or better.
Findings
In 2008, drug-related adverse outcomes were recorded in nearly 1.9 million inpatient hospital stays
Characteristics of hospital stays and ED visits with drug-related adverse outcomes
Among inpatient stays with drug-related adverse outcomes, the mean patient age was 62.8 years. However, as shown in table 1, when examined by type of drug-related adverse outcome, the mean age of patients in the hospital with poisoning was significantly lower (50.2 years) than that of patients with adverse effects (63.7 years).
full-text:
Statistical Brief #109
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