The Effect of Patient Safety Events on Elective Surgical Patients at US Academic Medical Centers

Objective: To determine the extent of the impact of a patient safety event on outcomes for elective surgical admissions at US academic medical centers. Methods:The study design was a retrospective cohort analysis. The UHC Clinical Database was used to evaluate inpatients from 106 US academic medical centers. The system was queried for the development of a cohort in which patients admitted for elective surgical procedure did not experience a urgical patient safety event and a cohort in which the patients did experience a surgical patient safety event during their inpatient stay. Outcomes for each cohort were length of stay, costs, 30 day readmissions and inpatient mortality. The UHC risk-adjustment methodology was used to compare observed rates to expected rates of resource utilization and mortality outcomes. Results: Over 500,000 cases were analyzed. 13,733 cases were found that had experienced a surgical patient safety event during their inpatient stay. The incidence rate of a patient safety event occurring was 26.1/1,000 discharges [2.6%]. The mortality rate, mean length of stay, mean cost and 30 day readmission rate for those patients in the cohort without a post surgery patient safety event occurring was 0.32%, 4.43 days, $17,197 and 8.06%, respectively. The LOS and mortality rates were lower at a 0.01 level of statistical significance than expected. Costs were higher than expected at a 0.01 level of significance. The mortality rate, mean length of stay, mean cost and 30 day readmission rate for those patients in the cohort with a patient safety event occurring was 9.31%, 15.25 days, $51,500 and 16.24% , respectively. The mean LOS, mean cost and mortality rate were higher at a .01 level of statistical significance than expected. Conclusion: Higher mortality rates, 30 day readmission rates, mean LOS and cost are associated with the occurrence of a patient safety events among surgical inpatients admitted electively to academic medical centers.