Research Activities #286, June 2004

experience adverse patient safety events— such as medical injuries or errors—in the course of their care. Those in vulnerable populations, including children under 1 year old are at highest risk for medical injuries related to hospitalization, according to a new study conducted by researchers at the Agency for Healthcare Research and Quality. The study, which uses the recently developed Patient Safety Indicators (PSIs) to focus on children in hospitals, examined 5.7 million hospital discharge records for children under age 19 from 27 States. The data were drawn from the 2000 Healthcare Cost and Utilization Project State Inpatient Database. This is one of the first studies to quantify the impact of patient safety events on children in terms of excess hospital stays and charges, as well as the increased risk of death among children due to medical errors. In total, the PSIs identified 51,615 patient safety events involving children in hospitals during 2000. Children up to 1 year old were consistently and significantly more likely to experience many of the events identified by the PSIs than older children. Children whose primary insurance was Medicaid also were more likely to experience several of the PSI events. The prevalence of patient safety events resulting in injuries among children also had an impact on the length of stay, charges, and the rate of inhospital deaths. For example, infections resulting from medical care caused a 30-day increase in the average length of stay and resulted in increased charges of more than $121,000, on average, per discharge. In total, the combined excess charges for all PSI events are estimated to have exceeded $1 billion. Postoperative respiratory failure increased the rate of deaths in hospitals by as much as 76 percent. The researchers estimate that if all deaths among pediatric patients who experience a medical injury are attributed to those injuries, then Research Activities