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Value of improving patient safety: health economic considerations for rapid response systems–a rapid review of the literature and expert round table
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Dyfrig A Hughes ,
Sally Lewis ,
Emily A Holmes,
Cor Kalkman,
Ralph So,
Sumeshni Tranka,
John Welch
BMJ Open, Volume: 13, Issue: 4, Start page: e065819
Swansea University Author:
Sally Lewis
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© Author(s) (or their employer(s)) 2023. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY- NC 4.0) license.
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DOI (Published version): 10.1136/bmjopen-2022-065819
Abstract
Objectives Failure to rescue deteriorating patients in hospital is a well-researched topic. We aimed to explore the impact of safer care on health economic considerations for clinicians, providers and policymakers.Design We undertook a rapid review of the available literature and convened a round ta...
| Published in: | BMJ Open |
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| ISSN: | 2044-6055 2044-6055 |
| Published: |
BMJ
2023
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa71009 |
| Abstract: |
Objectives Failure to rescue deteriorating patients in hospital is a well-researched topic. We aimed to explore the impact of safer care on health economic considerations for clinicians, providers and policymakers.Design We undertook a rapid review of the available literature and convened a round table of international specialists in the field including experts on health economics and value-based healthcare to better understand health economics of clinical deterioration and impact of systems to reduce failure to rescue.Results Only a limited number of publications have examined the health economic impact of failure to rescue. Literature examining this topic lacked detail and we identified no publications on long-term cost outside the hospital following a deterioration event. The recent pandemic has added limited literature on prevention of deterioration in the patients’ home.Cost-effectiveness and cost-efficiency are dependent on broader system effects of adverse events. We suggest including the care needs beyond the hospital and loss of income of patients and/or their informal carers as well as sickness of healthcare staff exposed to serious adverse events in the analysis of adverse events. They are likely to have a larger health economic impact than the direct attributable cost of the hospital admission of the patient suffering the adverse event. Premorbid status of a patient is a major confounder for health economic considerations.Conclusion In order to optimise health at the population level, we must limit long-term effects of adverse events through improvement of our ability to rapidly recognise and respond to acute illness and worsening chronic illness both in the home and the hospital. |
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| College: |
Faculty of Humanities and Social Sciences |
| Funders: |
This work was supported by an Improvement Science Fellowship from the Health Foundation (AIMS 109280). |
| Issue: |
4 |
| Start Page: |
e065819 |