Cost of Hospital-Acquired Diagnoses

In 2007, the Commission engaged the University of Queensland to learn more about the economic costs of adverse events in Australia. This work included the development of a new Australian tool to better characterise in–hospital patient illness and injury: the Classification of Hospital Acquired Diagnoses (CHADx or ‘chaddix’). CHADx is based on the validation of the grouping system to characterise the majority of in-hospital complications to assist in measurement of the economic cost of patient injury or illness. It will enable appropriate prioritisation of patient safety programs through development of a tool for monitoring the impact of patient safety interventions.

Data on patient safety performance is an important tool for use by hospitals and others in reducing the rate of hospital-acquired illness and injury. But prospective collection of such data, or even undertaking retrospective chart review, is very costly. CHADx offers a pragmatic method of quantifying the cost of unsafe and poor quality health services to admitted patients, taking advantage of the early adoption in Victoria and Queensland of the "present on admission" flag in administrative data. The costing method researched has the potential for supporting both savings and safety improvement, as it could allow hospitals to track both the incidence and costs of hospital acquired diagnoses. Articles published on the CHADx method include:

• Jackson TJ, Michel JL, Roberts RF, Jorm CM, Wakefield JG, A classification of hospital-acquired diagnoses for use with routine hospital data, Med J Aust 2009; 191 (10): 544-548


• Michel JL, Nghiem HS, Jackson TJ, Using ICD-10-AM codes to characterise hospital-acquired complications, Health Information Management Journal Vol 38 No 3 2009


• Michel JL, Jackson TJ, Australian hospital data: not just for funding, Health Information Management Journal Vol 38 No 1 2009


• Jackson TJ, Michel JL, Roberts RF, Shepheard J, Cheng D, Rust J, Perry C, Development of a validation algorithm for 'present on admission' flagging, BMC Medical Informatics and Decision Making 2009, 9:48


• Jackson TJ, Moje C, Shepheard J, McMillan A, Monitoring sentinel events using routine inpatient data (PDF 85 KB), Asia Pacific Journal of Health Management, December, 2009 4(2): 39-46.


• New P, Jackson TJ, The costs and adverse events associated with hospitalization of patients with spinal cord injury in Victoria, Australia, Spine, April, 2010.


• Classification of Hospital Acquired Diagnoses (CHADx), Coding Matters Vol 17 Number 1 2010 (PDF 68 KB)*