Inpatient patient safety events in vulnerable populations: a retrospective cohort study
| العنوان: | Inpatient patient safety events in vulnerable populations: a retrospective cohort study |
|---|---|
| المؤلفون: | Jennifer P. Stevens, Lucy B. Schulson, Bruce E. Landon, Patricia Folcarelli, Victor Novack |
| المصدر: | BMJ qualitysafety. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | business.industry, 030503 health policy & services, Health Policy, Ethnic group, Retrospective cohort study, Lower risk, Rate ratio, Health equity, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Health care, Medicine, 030212 general & internal medicine, 0305 other medical science, business, Medicaid, Demography |
| الوصف: | BackgroundWidespread attention to structural racism has heightened interest in disparities in the quality of care delivered to racial/ethnic minorities and other vulnerable populations. These groups may also be at increased risk of patient safety events.ObjectiveTo examine differences in inpatient patient safety events for vulnerable populations defined by race/ethnicity, insurance status and limited English proficiency (LEP).DesignRetrospective cohort study.SettingSingle tertiary care academic medical centre.ParticipantsInpatient admissions of those aged ≥18 years from 1 October 2014 to 31 December 2018.MeasurementsPrimary exposures of interest were self-identified race/ethnicity, Medicaid insurance/uninsured and LEP. The primary outcome of interest was the total number of patient safety events, defined as any event identified by a modified version of the Institute for Healthcare Improvement global trigger tool that automatically identifies patient safety events (‘automated’) from the electronic record or by the hospital-wide voluntary provider reporting system (‘voluntary’). Negative binomial models were used to adjust for demographic and clinical factors. We also stratified results by automated and voluntary.ResultsWe studied 141 877 hospitalisations, of which 13.6% had any patient safety event. In adjusted analyses, Asian race/ethnicity was associated with a lower event rate (incident rate ratio (IRR) 0.89, 95% CI 0.83 to 0.96); LEP patients had a lower risk of any patient safety event and voluntary events (IRR 0.91, 95% CI 0.87 to 0.96; IRR 0.89, 95% CI 0.85 to 0.94). Asian and Latino race/ethnicity were also associated with a lower rate of voluntary events but no difference in risk of automated events. Black race was associated with an increased risk of automated events (IRR 1.11, 95% CI 1.03 to 1.20).LimitationsThis is a single centre study.ConclusionsA commonly used method for monitoring patient safety problems, namely voluntary incident reporting, may underdetect safety events in vulnerable populations. |
| تدمد: | 2044-5423 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::507f8e64393b97be8948e0004189b902 https://pubmed.ncbi.nlm.nih.gov/33106277 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....507f8e64393b97be8948e0004189b902 |
| قاعدة البيانات: | OpenAIRE |
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These groups may also be at increased risk of patient safety events.ObjectiveTo examine differences in inpatient patient safety events for vulnerable populations defined by race/ethnicity, insurance status and limited English proficiency (LEP).DesignRetrospective cohort study.SettingSingle tertiary care academic medical centre.ParticipantsInpatient admissions of those aged ≥18 years from 1 October 2014 to 31 December 2018.MeasurementsPrimary exposures of interest were self-identified race/ethnicity, Medicaid insurance/uninsured and LEP. The primary outcome of interest was the total number of patient safety events, defined as any event identified by a modified version of the Institute for Healthcare Improvement global trigger tool that automatically identifies patient safety events (‘automated’) from the electronic record or by the hospital-wide voluntary provider reporting system (‘voluntary’). Negative binomial models were used to adjust for demographic and clinical factors. 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