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The Diabetes Educator

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Medical Care Research and Review
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Using Patient Safety Indicators to Estimate the Impact of Potential Adverse Events on Outcomes

Peter E. Rivard

VA Boston Healthcare System

Stephen L. Luther

James A. Haley VA Medical Center

Cindy L. Christiansen

Boston University School of Public Health

Shibei Zhao

VA Center for Healthcare Quality, Outcomes and Economic Research

Susan Loveland

VA Center for Healthcare Quality, Outcomes and Economic Research

Anne Elixhauser

Agency for Healthcare Research and Quality

Patrick S. Romano

University of California, Davis

Amy K. Rosen

VA Center for Healthcare Quality, Outcomes and Economic Research

The authors estimated the impact of potentially preventable patient safety events, identi- fied by Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs), on patient outcomes: mortality, length of stay (LOS), and cost. The PSIs were applied to all acute inpatient hospitalizations at Veterans Health Administration (VA) facil- ities in fiscal 2001. Two methods—regression analysis and multivariable case matching— were used independently to control for patient and facility characteristics while predicting the effect of the PSI on each outcome. The authors found statistically significant (p < .0001) excess mortality, LOS, and cost in all groups with PSIs. The magnitude of the excess varied considerably across the PSIs. These VA findings are similar to those from a previously published study of nonfederal hospitals, despite differences between VA and non-VA systems. This study contributes to the literature measuring outcomes of medical errors and provides evidence that AHRQ PSIs may be useful indicators for comparison across delivery systems.

Key Words: patient safety • patient safety indicators • outcomes • mortality • cost

Medical Care Research and Review, Vol. 65, No. 1, 67-87 (2008)
DOI: 10.1177/1077558707309611
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