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住院儿科患者安全事件中的不平等情况按类别分类
Matthew S Pantell1,2, Kayla L Karvonen3, Paige Porter4
1Divisions of Pediatric Hospital Medicine.
Hospital pediatrics
|November 11, 2024
概括
儿科患者安全事件 (PSEs) 和不良事件 (AE) 在种族,种族和保险人群中分布不公平. 药物和线路/管道是儿童医院这些差异的关键驱动因素.
科学领域:
- 儿童患者的安全性
- 健康 公平 研究 健康 公平 研究
- 医疗保健的不平等 医疗保健的不平等
背景情况:
- 患者安全事件 (PSE) 和不良事件 (AE) 是儿科环境中护理质量的关键指标.
- 现有的研究还没有充分探讨PSE和AE在各种人口因素 (包括种族,种族,保险和语言) 的不平等.
- 自愿事件报告 (IR) 为分析这些安全事件提供了有价值的,尽管可能有限的数据来源.
研究的目的:
- 根据种族和种族,保险支付人和语言,调查儿科患者安全事件 (PSE) 和不良事件 (AE) 的潜在不平等情况.
- 根据严重程度和事件类别分析公共事件,以确定差异的具体驱动因素.
- 使用自愿事件报告 (IR) 作为本分析的主要数据来源.
主要方法:
- 进行了一项回顾性队列研究,分析了从2012年1月19日至2019年12月31日在美国城市三级护理儿童医院的儿科住院病例.
- 来自85,458次住院的数据被检查,以比较PSE和AE的总体率,根据严重程度和事件类别.
- 事件率比率 (IRR) 用于评估人口统计因素 (种族,种族,保险,语言) 和安全事件之间的关联,控制共变量.
主要成果:
- 与参考组相比,拉丁人和非拉丁裔黑人/非裔美国儿童住院的PSE发生率较高 (两者的IRR为1.17).
- 公共保险和非私人/非公共保险的儿童也经历了更高的PSE率 (IRR分别为1.10和1.12).
- 对AE观察到类似的模式,拉丁语患者显示出显著的关联. 药物,液体或血液以及线路或管道PSEs是造成不平等的主要原因.
结论:
- 该研究发现了儿童患者安全事件和不良事件的显著不平等,如在事件报告中记录的,与种族,种族和保险支付人相关.
- 这些发现表明,与这些人口因素相关的护理质量可能存在差异.
- 局限性包括单一中心分析,特定机构的事件类别,以及事件报告的自愿性.
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