Date of Award

Fall 8-2020

Degree Name

Doctor of Public Health (DrPH)

Advisor(s)

ROBERT O. MORGAN

Second Advisor

LUISA FRANZINI

Third Advisor

MARIA .E.FERNANDEZ

Abstract

Background: Twenty years post IOM’s landmark publication, “To Err is Human: Building a Safer Health System”, still no consensus on case definition for patient safety events (PSEs). Available data on incidence and magnitude of PSEs are more than 10 years old, while data on disparities are ambiguous. Objective: To examine the racial and socioeconomic disparities in reported patient safety events (PSEs) among hospitalized individuals. Design, Setting, and Participants: Cross-sectional study of patient safety events using the 2016 National Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP). A total of 6,753,100 discharges were identified as being at risk for PSEs using AHRQ’s patient safety indicator (PSI) algorithm. Main Outcome Measure: Patient Safety events (PSE). Results: 1299 PSEs occurred per 100000 discharges in 2016. Racial and ethnic minority groups were significantly more likely to experience at least one or more PSEs when compared to White non-Hispanic group (AOR: Blacks-1.33, Asians-1.51, and Hispanics-1.06). Black patients were more likely to experience Pressure Ulcer, Central Venous CatheterRelated Blood Stream Infection, Perioperative Pulmonary Embolism or Deep Vein Thrombosis; Asian patients were more likely to experience Obstetric traumas and inhospital deaths among patients with serious treatable conditions. Hispanics were more likely to experience pressure ulcers. Discharges with Medicaid insurance coverage and those without coverage appear to be less likely to experience a PSE when compared to those on private insurance coverage. In contrast, discharges with Medicare insurance coverage were more likely to experience at least one or more PSEs when compared to those on private insurance coverage. Conclusions: The burden of patient safety events remain high. Pressure ulcers appears to be driving overall burden of PSEs for Blacks and Hispanics; whereas obstetric traumas appear to be the driving force for Asians. Further research is required to understand the factors that predispose each group to these PSEs.

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