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Estimation du surcoût des événements indésirables associés aux soins à l'hôpital en France

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Author Info

  • Clément Nestrigue

    ()
    (IRDES institut for research and information in health economics)

  • Zeynep Or

    ()
    (IRDES institut for research and information in health economics)

Abstract

Les événements indésirables associés aux soins (EIS) représentent non seulement un problème de sécurité et de qualité des soins pour les patients, mais également un problème économique puisque leurs conséquences financières peuvent être importantes. Cependant, jusqu’ici en France, il n’y avait aucune étude de coût à l’échelle nationale regardant l’impact économique des événements indésirables associés aux soins. Notre étude exploite les données hospitalières collectées en routine afin d’établir l’importance et les conséquences économiques de neuf EIS à l’hôpital. Nous avons suivi la méthodologie développée aux Etats-Unis pour construire des indicateurs de sécurité des patients (PSI) et dénombrer les EIS à l’hôpital. Les surcoûts et allongements de durées de séjour liés aux EIS sont mesurés selon deux méthodes : la méthode de stratification et l’analyse de régression. Les résultats montrent qu’environ 0,5 % des séjours hospitaliers sont associés à l’un ou l’autre des neuf événements indésirables évalués dans notre étude. Il existe toutefois de fortes disparités de surcoûts, ceux-ci pouvant varier de près de 500 € pour les traumatismes obstétricaux à plus de 15 000 € pour les septicémies. Ces surcoûts sont étroitement corrélés avec la durée des séjours et l’intensité des soins. Quatre événements indésirables (désordres physiologiques et métaboliques postopératoires, septicémies, escarres et embolies pulmonaires) concentrent 90 % du coût total de prise en charge des événements indésirables en 2007. Notre étude contribue à repérer les domaines où intervenir en priorité et cibler les ressources visant à l’amélioration de la sécurité des patients.

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File URL: http://www.irdes.fr/EspaceRecherche/DocumentsDeTravail/DT44EstimationSurcoutsEvenementsIndesSoinsHopitalFrance.pdf
File Function: First version, 2012
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Bibliographic Info

Paper provided by IRDES institut for research and information in health economics in its series Working Papers with number DT44.

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Length: 30 pages
Date of creation: Feb 2012
Date of revision: Feb 2012
Handle: RePEc:irh:wpaper:dt44

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Related research

Keywords: événements indésirables; indicateurs de sécurité; qualité des soins; coût; PMSI.;

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Cited by:
  1. Mohamed Ali Ben Halima & Thierry Debrand & Camille Regaert, 2012. "Sick Leaves: Understanding Disparities Between French Departments," Working Papers DT50, IRDES institut for research and information in health economics, revised Oct 2012.
  2. Catherine Pollak, 2012. "Employed and Happy despite Weak Health? Labour Market Participation and Job Quality of Older Workers with Disabilities," Working Papers DT45, IRDES institut for research and information in health economics, revised Mar 2012.
  3. Catherine Pollak & Nicolas Sirven, 2012. "Active Ageing Beyond the Labour Market: Evidence on Work Environment Motivations," Working Papers DT48, IRDES institut for research and information in health economics, revised May 2012.
  4. Luiz Flavio Andrade, 2012. "Entry Time Effects and Follow-on Drugs Competition," Working Papers DT49, IRDES institut for research and information in health economics, revised Jun 2012.
  5. Caroline Berchet & Nicolas Sirven, 2012. "Cross-Country Performance in Social Integration of Older Migrants. A European Perspective," Working Papers DT46, IRDES institut for research and information in health economics, revised Mar 2012.

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