The Health Care Cost of Drug-Related Morbidity and Mortality in Nursing Facilities

doi:10.1001/archinte.1997.00440390083011

You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.

Vol. 157 No. 18, 13 OCTOBER 1997

Online Only
	•	Online First Table of Contents

ORIGINAL INVESTIGATIONS

•	Online Features

This Article
•	References
•	Full text PDF
•	Reply to article
•	Send to a friend
•	Save in My Folder
•	Save to citation manager
•	Permissions

Citing Articles
•	Citation map
•	Citing articles on HighWire
•	Citing articles on Web of Science (92)
•	Contact me when this article is cited

Related Content
•	Similar articles in this journal

Social Bookmarking
	What's this?

The Health Care Cost of Drug-Related Morbidity and Mortality in Nursing Facilities

J. Lyle Bootman, PhD; LTC Donald L. Harrison, PhD; Emily Cox, PhD

Arch Intern Med. 1997;157(18):2089-2096.

Abstract

Background
Preventable drug-related morbidity and mortality within nursingfacilities represent a serious problem urgently requiring expertmedical attention. The health care costs of drug-related problemscan be both immense and avoidable. However, the research todate has been narrow in scope, focusing on the drug costs avoidedand failing to consider the wider range of possible negativeoutcomes and potential drug-related problems.

Objectives
To develop a model of therapeutic outcomes resulting from drugtherapy within nursing facilities, to estimate the magnitudeof the cost of drugrelated morbidity and mortality within nursingfacilities in the United States, and to assess the impact ofpharmacist-conducted, federally mandated, monthly, retrospectivereview of nursing facility residents' drug regimens in reducingthe cost of drug-related morbidity and mortality.

Methods
Using decision analysis techniques, a probability pathway modelwas developed to estimate the cost of drug-related problemswithin nursing facilities. An expert panel consisting of consultantpharmacists and physicians with practice experience in nursingfacilities and geriatric care was surveyed to determine conditionalprobabilities of therapeutic outcomes attributable to drug therapy.Health care utilization and associated costs derived from negativetherapeutic outcomes were estimated.

Results
Baseline estimates indicate that the cost of drugrelated morbidityand mortality with the services of consultant pharmacists was$4 billion compared with $7.6 billion without the services ofconsultant pharmacists.

Conclusions
Drug-related morbidity and mortality in nursing facilities representa serious economic problem. For every dollar spent on drugsin nursing facilities, $1.33 in health care resources are consumedin the treatment of drug-related problems. With the currentfederally mandated drug regimen review, it is estimated thatconsultant pharmacists help to reduce health care resourcesattributed to drug-related problems in nursing facilities by$3.6 billion.

Arch Intern Med. 1997;157:2089-2096

Author Affiliations

From the Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson (Drs Bootman and Cox), and the Clinical Investigation Regulatory Office, Fort Sam Houston, Tex (Dr Harrison).

Add to CiteULike CiteULike Add to Connotea Connotea Add to Delicious Delicious Add to Digg Digg Facebook Add to Reddit Reddit Add to Technorati Technorati Twitter What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Medication safety in residential aged-care facilities: a perspective
Wilson et al.
Therapeutic Advances in Drug Safety 2010;1:11-20.
ABSTRACT

Specialist medication review does not benefit short-term outcomes and net costs in continuing-care patients
Pope et al.
Age Ageing 2010;0:afq095v1-afq095.
ABSTRACT | FULL TEXT

Pharmacist Approach to Geriatrics
Hutchison
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2010;4:267-274.
ABSTRACT

Polypharmacy in Older Adults with Cancer
Maggiore et al.
The Oncologist 2010;15:507-522.
ABSTRACT | FULL TEXT

START (screening tool to alert doctors to the right treatment) an evidence-based screening tool to detect prescribing omissions in elderly patients
Barry et al.
Age Ageing 2007;36:632-638.
ABSTRACT | FULL TEXT

ASHP Long-Range Vision for the Pharmacy Work Force in Hospitals and Health Systems: Ensuring the Best Use of Medicines in Hospitals and Health Systems
Am J Health Syst Pharm 2007;64:1320-1330.
FULL TEXT

Compelling features of a safe medication-use system.
Kelly and Rucker
Am J Health Syst Pharm 2006;63:1461-1468.
FULL TEXT

Aging Biology and Geriatric Clinical Pharmacology
McLean and Le Couteur
Pharmacol. Rev. 2004;56:163-184.
ABSTRACT | FULL TEXT

Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults: Results of a US Consensus Panel of Experts
Fick et al.
Arch Intern Med 2003;163:2716-2724.
ABSTRACT | FULL TEXT

Errors in health care management: what do they cost?
Rigby and Litt
BMJQS 2000;9:216-221.
ABSTRACT | FULL TEXT

Discrepancies in the Use of Medications: Their Extent and Predictors in an Outpatient Practice
Bedell et al.
Arch Intern Med 2000;160:2129-2134.
ABSTRACT | FULL TEXT

| | |