An Observational Study of Disparities in Voluntary Event Reporting in a Large Academic Health System

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Health equity

Background:

• Voluntary event reporting (VER) is crucial for patient safety but is subject to bias and under-reporting.
• Existing research suggests VER may create disparities in reported safety events.
• Understanding these disparities is essential for equitable healthcare delivery.

Purpose of the Study:

• To investigate disparities in voluntary event reporting (VER) within a large academic health system.
• To identify demographic and socioeconomic factors associated with under- or over-reporting of patient safety events.

Main Methods:

• Retrospective review of inpatient safety events reported via the VER system (April 2021-July 2022).
• Comparison of demographics of reported events with the overall admitted patient population.
• Analysis included novel variables beyond standard demographic data.

Main Results:

• Pediatric patients were over-represented overall but under-represented in high-harm events.
• Female patients were under-represented in the VER system, particularly in lower-harm events.
• Certain groups, including English-speaking, non-Hispanic/Latino, Black/African American patients, and those from high deprivation areas, were over-represented in VER.

Conclusions:

• Significant disparities in voluntary event reporting were identified in the academic health system.
• Novel variables revealed important reporting biases.
• Further research is needed to understand and mitigate these disparities, potentially through more objective event detection methods.