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Factors Associated With Likelihood of Experiencing a Pediatric Safety Event in the Inpatient Setting

Senayit Demie1, Jennifer Lee2, Katharine Cunnane3

  • 1Departments of Pediatrics, Morehouse School of Medicine, Atlanta, Georgia.

Journal of Patient Safety
|August 12, 2026
PubMed

Insights

Hospitalized children with public insurance face higher risks of safety events. Race/ethnicity and preferred language did not significantly impact safety event occurrence in this pediatric study.

Area of Science:

  • Pediatric healthcare quality and patient safety.
  • Health equity and disparities in medical care.
  • Hospital-acquired conditions and adverse events.

Background:

  • Adult studies indicate marginalized populations experience higher hospital harm.
  • Understanding disparities in pediatric patient safety is crucial.
  • Previous research highlighted race/ethnicity and language as risk factors.

Purpose of the Study:

  • To investigate the association between patient demographics and safety events in hospitalized children.
  • To examine if race/ethnicity, preferred language, or insurance type correlate with adverse events in pediatric care.
  • To identify specific demographic factors contributing to safety events in pediatric hospitalizations.

Main Methods:

  • Retrospective observational study of safety event reports from two tertiary children's hospitals (2020-2022).
  • Inclusion of pediatric patients (≤18 years) across neonatal intensive care, pediatric intensive care, and inpatient units.
  • Multivariable logistic regression analysis after matching patients by age, sex, and unit to assess demographic effects on safety events.

Main Results:

  • Of 4112 unique pediatric patients, 9% experienced a reported safety event, with medication errors constituting 76%.
  • No statistically significant differences in safety event likelihood were found based on race/ethnicity or primary language.
  • Patients with public insurance had significantly higher odds (OR=1.51) of experiencing a safety event compared to those with private insurance.

Conclusions:

  • Public insurance status is a significant predictor of safety events in hospitalized pediatric patients.
  • Unlike adult studies, race/ethnicity and preferred language were not associated with safety events in this pediatric cohort.
  • Further research is needed to understand the structural factors driving health inequities related to insurance status in pediatric care.
Abstract

Keywords:
health disparitieshealth equityinpatient careinsurance statuspatient safetypediatric hospital medicinepreferred languagerace and ethnicitysocial determinants of healthvoluntary safety reporting

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