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Hospital-reported medical errors in children.

Anthony D Slonim1, Bonnie J LaFleur, Wendy Ahmed

  • 1Center for Health Services and Clinical Research, Children's Research Institute, Children's National Medical Center, Washington, DC 20010, USA. aslonim@cnmc.org

Pediatrics
|March 4, 2003
PubMed
Summary

Medical errors in hospitalized children were studied from 1988-1997. Higher rates were linked to higher income, special medical needs, and urban teaching hospitals.

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Area of Science:

  • Pediatric Healthcare Research
  • Patient Safety
  • Medical Error Analysis

Background:

  • Medical errors are a significant concern in adult hospitalizations.
  • Pediatric medical errors are understudied with limited published research.
  • Understanding pediatric medical error rates is crucial for improving child healthcare.

Purpose of the Study:

  • To determine national rates of hospital-reported medical errors in pediatric inpatients from 1988 to 1997.
  • To identify patient and hospital characteristics associated with these medical errors.
  • To provide data for targeted interventions to reduce pediatric medical errors.

Main Methods:

  • A nonconcurrent cohort study design was employed.
  • Data from the Healthcare Cost and Utilization Project (HCUP) for 1988, 1991, 1994, and 1997 were analyzed.

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  • Included were hospitalized nonnewborn pediatric patients (<=18 years) in the United States.

    • Main Results:

    • National rates of hospital-reported medical errors in children ranged from 1.81 to 2.96 per 100 discharges.
    • Rates were lower in 1988, with no significant changes in subsequent years.
    • Higher median household income, special medical needs, and dependence on medical technology were associated with increased error rates.
    • Private for-profit hospitals reported lower rates, while urban teaching hospitals reported higher rates.

    Conclusions:

    • Administrative data offer insights but have limitations for studying medical errors.
    • Children with special medical needs represent a key area for further detailed investigation.
    • Findings suggest specific hospital types and patient demographics warrant focused safety initiatives.