No one would argue with the need to ensure all children receive safe, high-quality health care. Are there disparities in the risk of having an adverse safety event based on personal characteristics, such as race or ethnicity? Parikh et al. (10.1542/peds.2023-063714) set out to answer this question by analyzing data on patient safety by race, ethnicity, and payor status from a retrospective population-based sample of 5.2 million hospitalized children in the 2019 Kids’ Inpatient Database (KID). The KID is maintained by the Agency for Healthcare Research and Quality (AHRQ) and is updated every three years. The authors categorized adverse safety events in terms of 7 pediatric safety indicators or metrics established by AHRQ. These included post-operative events involving hemorrhage, sepsis, and respiratory failure, blood stream infections, accidental puncture or laceration injury while hospitalized, and iatrogenic pneumothorax. The authors found that Black and Hispanic patients compared with non-Hispanic White patients had greater odds of a reportable safety event in 5 of these 7 AHRQ indicators. Patients enrolled in Medicaid had greater odds of experiencing a safety event in 4 of the 7 indicators, with post-operative sepsis showing the largest disparity. However, safety disparities persisted by race and ethnicity even among privately insured patients.
What can we do about these disparities? To answer that we invited a commentary from Dr. Anne Lyren from UH Rainbow Babies and Children’s Hospital in Cleveland who is also the Clinical Director of the Solutions for Patient Safety National Network (10.1542/peds.2023-064741). Dr. Lyren issues a call to action for us to acknowledge these safety disparities and work to eliminate them. One way to do this is using a three-step strategy suggested by Parikh et al. in the Discussion section of their study: 1) describe the problem using all available data; 2) partner with the community and families affected by the disparities; and 3) implement quality-improvement interventions. Link to this study and commentary and see how you can be part of the solution to inequitable risk of adverse safety events.
