Racial Disparities in Patient Safety Indicator (PSI) Rates in the Veterans Health Administration

Objective: The Patient Safety Indicators (PSIs) developed by the Agency for Healthcare Research and Quality identify potential patient safety events through administrative records. We sought to determine whether there were racial disparities in patient safety event rates in Veterans Health Administration (VHA) hospitals. Methods: We explored 5 years of VHA inpatient data for significant differences between racial/ethnic groups in their odds of experiencing PSIs. Results: No racial group had consistently higher or lower odds of experiencing PSIs. For example, African Americans had significantly higher odds of decubitus ulcer (OR = 1.35, P < 0.0001) and postoperative pulmonary embolism (PE)/deep vein thrombosis (DVT) (OR = 1.23, P < 0.0001) but significantly lower odds of accidental puncture or laceration (OR = 0.69, P = 0.0003) compared with whites. Conclusion: Although significant differences between racial/ethnic groups in the odds of experiencing PSIs were few, the underlying causes of the disparities that were found must be explored to understand how they can be eliminated and to improve patient safety for all patients.