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

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.

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

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.

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.

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.