Trends and Economic Impact of Medication Errors in Public Hospitals of Eastern Region Ghana: A Retrospective Analysis From 2018 to 2024
Author(s)
ARCHIBALD N. OKOTAH, MPH1, Leslie Vanderpuije, EMPA, FGCPharm1, Josephine Osarfo, MPH1, Isaac Obiri-Yeboa, MSc (Clin Pharm), FGCPharm2, Winfred Ofosu, MBChB, MPH2, NII OBODAI MENSAH, BSc, MSc, FPCPharm2, Daniel Buabin, MPSGH3.
1AJ Health and Research Consult, Accra, Ghana, 2Eastern Regional Health Directorate, Ghana Health Service, Eastern Region, Ghana, 3Tetteh Quarshie Memorial Hospital, Eastern Region, Ghana.
1AJ Health and Research Consult, Accra, Ghana, 2Eastern Regional Health Directorate, Ghana Health Service, Eastern Region, Ghana, 3Tetteh Quarshie Memorial Hospital, Eastern Region, Ghana.
OBJECTIVES: Medication errors are a significant challenge to patient safety and health system efficiency, particularly in low resource settings like Ghana. Despite increasing efforts to improve care quality, the financial burden of these errors is not well documented. This study assessed trends in medication error-related costs and analyzed clinical factors influencing their economic impact in public hospitals in Ghana’s Eastern Region.
METHODS: A retrospective descriptive design was conducted using medication error intervention forms submitted between 2018 and 2024. Cost data was computed using the National Health Insurance Scheme (NHIS) pricing framework, with year-on-year comparisons of pre- and post-intervention medication costs. Descriptive statistics and multiple linear regressions were performed using STATA version 15.
RESULTS: A total of 10,283 medication error cases were analyzed. The mean patient age was 40.7 years (±24.1 SD), with females accounting for 68% of cases. Most errors were identified by Pharmacists (65.4%) and originated during the ordering/prescribing stage (90.5%). The most prevalent error type was wrong dosage (57.3%), followed by wrong drug (18.4%) and wrong drug combinations (7.4%).The total pre-intervention cost of error was GH¢1,091,954 ($105,419), while post-intervention costs amounted to GH¢340,351 ($32,858), resulting in GH¢751,578 ($72,558) in savings —a 68.8% reduction. Cost savings varied annually - with the highest annual cost saving recorded in 2024 (GH¢503,906; 81.8 %). Despite these variations, the intervention consistently led to cost reductions, demonstrating its overall efficiency and potential for scale-up. Older age, particularly 65 years and above, was significantly associated with higher pre-intervention costs (GH¢115.4; p < 0.001).
CONCLUSIONS: This study highlights a persistently high burden of medication errors, especially wrong dosages during prescribing. Although significant cost savings were achieved through interventions, yearly variability in cost efficiency underscores the need for sustained improvements. Tailored strategies that consider patient age, error type, and health worker role are essential to enhance medication safety and economic efficiency
METHODS: A retrospective descriptive design was conducted using medication error intervention forms submitted between 2018 and 2024. Cost data was computed using the National Health Insurance Scheme (NHIS) pricing framework, with year-on-year comparisons of pre- and post-intervention medication costs. Descriptive statistics and multiple linear regressions were performed using STATA version 15.
RESULTS: A total of 10,283 medication error cases were analyzed. The mean patient age was 40.7 years (±24.1 SD), with females accounting for 68% of cases. Most errors were identified by Pharmacists (65.4%) and originated during the ordering/prescribing stage (90.5%). The most prevalent error type was wrong dosage (57.3%), followed by wrong drug (18.4%) and wrong drug combinations (7.4%).The total pre-intervention cost of error was GH¢1,091,954 ($105,419), while post-intervention costs amounted to GH¢340,351 ($32,858), resulting in GH¢751,578 ($72,558) in savings —a 68.8% reduction. Cost savings varied annually - with the highest annual cost saving recorded in 2024 (GH¢503,906; 81.8 %). Despite these variations, the intervention consistently led to cost reductions, demonstrating its overall efficiency and potential for scale-up. Older age, particularly 65 years and above, was significantly associated with higher pre-intervention costs (GH¢115.4; p < 0.001).
CONCLUSIONS: This study highlights a persistently high burden of medication errors, especially wrong dosages during prescribing. Although significant cost savings were achieved through interventions, yearly variability in cost efficiency underscores the need for sustained improvements. Tailored strategies that consider patient age, error type, and health worker role are essential to enhance medication safety and economic efficiency
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD117
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Patient-Centered Research
Disease
No Additional Disease & Conditions/Specialized Treatment Areas