Pediatric patient safety in hospitals: A national picture in 2000
Pediatric patient safety in hospitals: A national picture in 2000
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DOI：
10.1542/peds.113.6.1741
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发表时间：
2004-06-01
期刊：
影响因子：
8
通讯作者：
Zhan, CL
中科院分区：
文献类型：
--
作者：
Miller, MR;Zhan, CL
客观的。描述住院儿童的潜在患者安全事件，检查相关因素，并探讨安全事件的影响。方法。新发布的患者安全指标 (PSI) 由医疗保健研究和质量机构的研究人员开发，旨在利用管理数据识别潜在的院内患者安全问题，并应用于出院数据。在 2000 年医疗保健成本和利用项目中，对来自 27 个州的所有 570 万条 19 岁以下儿童的出院记录进行了 PSI 事件分析。检查了 PSI 事件的发生率以及与患者级别和医院级别特征的关联。根据患者病情严重程度进行多变量回归调整，用于估计安全事件对超额住院时间、费用和院内死亡率的影响。结果。儿科患者安全事件的发生率很高。 PSI 事件在幼儿和享受医疗补助保险的儿童以及一些最脆弱的住院儿童中发生的频率更高。回归分析发现，几乎所有 PSI 都与住院时间、费用和院内死亡的显着和实质性增加有关。使用此处得出的估计值和 2000 年数据中确定的实际病例数，我们估计 2000 年患者安全事件仅对儿童造成了超过 10 亿美元的超额费用。结论。住院儿童的患者安全问题经常发生，并对我们的医疗保健行业产生重大影响。这项研究无法衡量的是我们的患者被迫应对的安全事件的额外“成本”和“负担”。除了此处测量的结果之外，更好地描述和量化这些结果的额外工作可以帮助巩固患者安全工作的“业务案例”。
Objective. To describe potential patient safety events for hospitalized children, examine associated factors, and explore impacts of safety events.Methods. The newly released Patient Safety Indicators (PSIs), developed by researchers at the Agency for Healthcare Research and Quality to identify potential in-hospital patient safety problems using administrative data, were applied to hospital discharge data. All 5.7 million discharge records for children younger than 19 years from 27 states in the 2000 Healthcare Cost and Utilization Project were analyzed for PSI events. Prevalence of PSI events and associations with patient-level and hospital-level characteristics were examined. Multivariate regression adjusting for patient severity of illness was used to estimate impacts of safety events in terms of excess length of stay, charges, and in-hospital mortality.Results. The prevalence of pediatric patient safety events is significant. PSI events occurred more frequently in the very young and those on Medicaid insurance, some of the most vulnerable hospitalized children. Regression analysis found that almost all PSIs are associated with significant and substantial increases in length of stay, charges, and in-hospital death. Using the estimates derived here and the actual number of cases identified in the 2000 data, we estimate that patient safety events incurred >$ 1 billion in excess charges for children alone in 2000.Conclusions. Patient safety problems for hospitalized children occur frequently and with substantial impacts to our health care industry. Unmeasurable by this study are the additional "costs" and "burdens" of safety events that our patients are forced to handle. Additional work to describe and quantify better these outcomes in addition to ones measured here can help solidify the "business case" for patient safety efforts.