Study Identifies Adverse Events in Children's Hospitals

Researchers analyzed information from more than 430,000 discharges from 38 pediatric hospitals in the United States that participated in the Pediatric Health Information Systems database in 2006. They searched the database for 12 different adverse patient safety events, designated pediatric-specific quality indicators (PDIs) by the federal Agency for Healthcare Research and Quality (AHRQ). The adverse events included infections and other complications that occurred as unintended consequences of treatment and hospitalization.

“Our study was the first to use this pediatric-specific tool to screen for adverse events,” said co-author Matthew Kronman, M.D., a hospital-based specialist in infectious diseases at Children’s Hospital. “AHRQ had previously developed patient-safety indicators for adult patients, but some of those adverse events in adults, such as hip fractures after a fall in the hospital, were uncommon in children. Our findings suggest that the pediatric safety indicators reflect a better understanding of the situation of children.”

The excess length of hospital stay from PDI events ranged from 2.8 days for accidental puncture and laceration to 23.5 days for postoperative sepsis. Excess overall charges ranged from $34,884 for accidental puncture and laceration to $337,226 for in-hospital mortality after pediatric heart surgery. Among excess charges, the largest were for laboratory, room and nursing charges. The researchers adjusted charges to reflect geographical differences in prices and wages.

“Our findings may help guide physicians and hospital administrators toward changes in practices where even modest improvements could have a high impact in patient safety and in more efficient, less costly health care,” say the authors.; Source: Children's Hospital of Philadelphia