Computerized indicators of potential drug-related emergency department and hospital admissions

Abstract

Objectives: To computerize indicators of potential drug-related emergency department and hospital admissions and to report the incidence of these potential drug-related morbidities for a managed care organization.

Study design: Retrospective review of healthcare organizations' pharmacy and administrative claims databases.

Methods: Thirty-nine indicators were coded and were used in an automated search of claims data. The indicators of potential drug-related morbidities comprised a pattern of care and an associated adverse outcome. Poisson distribution regression analysis was performed to assess the association of patient factors with indicator positives.

Results: The incidence densities for indicator positives were 1.96 (95% confidence interval, 1.60-2.40) per 1000 patient-years in the general population and 13.6 (95% confidence interval, 8.8-20.2) per 1000 patient-years among older persons. Age, male sex, number of medical conditions, and number of medications from different classes were associated with an increased rate of indicator positives.

Conclusions: Indicators of potential drug-related morbidities can be fully automated and used to search through medical and pharmacy claims. The indicators investigated in this study show promise as a quality improvement tool and should be further developed and evaluated.