[Patient safety and quality problems--what is the cost?]

Available evidence indicates a sizable "poor quality and safety" problem in health care. Costs can be assigned but few studies have done so. This article, the second in a series of three, summarises research which has calculated the economic cost of these problems. Adverse drug events account for a major part of the problem and have been estimated to be approximately 1.5% of the UK NHS annual budget. Other quality deficiency problems that have been costed in various studies are the use of inefficient medical procedures, hospital acquired infections and variation in clinical practice. There are only a few studies reporting the effectiveness of different actions to reduce adverse events and waste, and even less evidence about the cost of these different interventions. There is, however, sufficient evidence to suggest certain actions would not only relieve considerable patient suffering, but would make significant economic savings for health care and society. When planning for interventions to improve quality and reduce safety deficiencies, the costs of the problem should be calculated and weighed against the costs of the intervention, i.e the "quality cost" should be estimated. It should be decided how a potential saving could be retained by a unit which has invested in such an intervention. The third article describes methods for estimating quality costs in health care.