Related Experiment Video
Updated: Jun 7, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Inequities in Inpatient Pediatric Patient Safety Events by Category
Matthew S Pantell1,2, Kayla L Karvonen3, Paige Porter4
1Divisions of Pediatric Hospital Medicine.
Insights
Pediatric patient safety events (PSEs) and adverse events (AEs) were inequitably distributed among racial, ethnic, and insured groups. Medication and lines/tubes were key drivers of these disparities in children's hospitals.
Area of Science:
- Pediatric Patient Safety
- Health Equity Research
- Healthcare Disparities
Background:
- Patient safety events (PSEs) and adverse events (AEs) are critical indicators of care quality in pediatric settings.
- Existing research has not fully explored inequities in PSEs and AEs across various demographic factors, including race, ethnicity, insurance, and language.
- Voluntary incident reports (IRs) offer a valuable, though potentially limited, data source for analyzing these safety events.
Purpose of the Study:
- To investigate potential inequities in pediatric patient safety events (PSEs) and adverse events (AEs) based on race and ethnicity, insurance payor, and language.
- To analyze PSEs by severity and event category to identify specific drivers of disparities.
- To utilize voluntary incident reports (IRs) as the primary data source for this analysis.
Main Methods:
- A retrospective cohort study was conducted, analyzing pediatric hospitalizations from January 19, 2012, to December 31, 2019, at a US urban tertiary care children's hospital.
- Data from 85,458 hospitalizations were examined to compare rates of PSEs and AEs overall, by severity, and by event category.
- Incident rate ratios (IRRs) were used to assess associations between demographic factors (race, ethnicity, insurance, language) and safety events, controlling for covariates.
Main Results:
- Hospitalizations involving Latinx and non-Latinx Black/African American children showed higher rates of PSEs compared to reference groups (IRR 1.17 for both).
- Publicly insured and non-privately/non-publicly insured children also experienced higher PSE rates (IRR 1.10 and 1.12, respectively).
- Similar patterns were observed for AEs, with Latinx patients showing a significant association. Medication, fluid, or blood and lines or tubes PSEs were major contributors to inequities.
Conclusions:
- The study identified significant inequities in pediatric patient safety events and adverse events, as recorded in incident reports, linked to race, ethnicity, and insurance payor.
- These findings suggest potential differences in care quality related to these demographic factors.
- Limitations include the single-center analysis, institution-specific event categories, and the voluntary nature of incident reporting.
Objectives:
Few studies have analyzed potential inequities in both pediatric patient safety events (PSEs) and adverse events (AEs) - PSEs leading to harm - nor in PSEs by event type. We sought to examine potential inequities in rates of pediatric PSEs overall, by severity, and by category based on race and ethnicity, insurance payor, and language as measured using voluntary incident reports (IRs).
Methods:
We conducted a retrospective cohort study of pediatric hospitalizations between January 19, 2012 through December 31, 2019 at a US urban, tertiary care children's hospital. Analyzing 85 458 hospitalizations, we compared PSEs overall, by severity, and by event category by race and ethnicity, insurance payor, and language using incident rate ratios (IRRs).
Results:
In models controlling for covariates, we found that hospitalizations of Latinx (IRR 1.17, 95% confidence interval [CI] 1.07-1.29), non-Latinx Black/African American (IRR 1.17, 95% CI 1.01-1.34), publicly insured (IRR 1.10, 95% CI 1.02-1.20), and nonprivately/nonpublicly insured (IRR 1.12, 95% CI 1.02-1.23) children had higher rates of PSEs compared with reference groups, but the association between language and PSEs was not significant. There were similar patterns among AEs, although only the association between hospitalizations of Latinx patients and AEs was significant. Medication, fluid, or blood and lines or tubes PSEs drove many inequities.
Conclusions:
We found inequities in PSEs as recorded by IRs, suggesting differences in care related to race, ethnicity, and payor. Limitations include analysis of a single center, that event categories are unique to the institution analyzed, and the voluntary nature of IRs.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:21Types of Reports II: Incident or Occurrence Report
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
01:25Ethical Standards I
The Code of Ethics provisions outline the nurse's duty to the patient, the healthcare team, the profession, and society. The Code's fundamental principles include advocacy,...
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:21Methods of Documentation III: PIE
01:18Guidelines and Strategies for Safe Computer Charting
Maintain Confidentiality and Security: