Racial and ethnic disparities in common inpatient safety outcomes in a children's hospital cohort.
BMJ Qual Saf
; 33(2): 86-97, 2024 01 19.
Article
en En
| MEDLINE
| ID: mdl-37460119
ABSTRACT
BACKGROUND:
Emerging evidence has shown racial and ethnic disparities in rates of harm for hospitalised children. Previous work has also demonstrated how highly heterogeneous approaches to collection of race and ethnicity data pose challenges to population-level analyses. This work aims to both create an approach to aggregating safety data from multiple hospitals by race and ethnicity and apply the approach to the examination of potential disparities in high-frequency harm conditions.METHODS:
In this cross-sectional, multicentre study, a cohort of hospitals from the Solutions for Patient Safety network with varying race and ethnicity data collection systems submitted validated central line-associated bloodstream infection (CLABSI) and unplanned extubation (UE) data stratified by patient race and ethnicity categories. Data were submitted using a crosswalk created by the study team that reconciled varying approaches to race and ethnicity data collection by participating hospitals. Harm rates for race and ethnicity categories were compared with reference values reflective of the cohort and broader children's hospital population.RESULTS:
Racial and ethnic disparities were identified in both harm types. Multiracial Hispanic, Combined Hispanic and Native Hawaiian or other Pacific Islander patients had CLABSI rates of 2.6-3.6 SD above reference values. For Black or African American patients, UE rates were 3.2-4.4 SD higher. Rates of both events in White patients were significantly lower than reference values.CONCLUSIONS:
The combination of harm data across hospitals with varying race and ethnicity collection systems was accomplished through iterative development of a race and ethnicity category framework. We identified racial and ethnic disparities in CLABSI and UE that can be addressed in future improvement work by identifying and modifying care delivery factors that contribute to safety disparities.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_acesso_equitativo_servicos
/
1_desigualdade_iniquidade
Asunto principal:
Etnicidad
/
Pacientes Internos
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Equity_inequality
Límite:
Child
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
BMJ Qual Saf
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos