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大型医疗体系中医疗事故事件数据库中的种族差异。

Race Differences in a Malpractice Event Database in a Large Healthcare System.

机构信息

From the MedStar Health Research Institute, Washington, DC.

出版信息

J Patient Saf. 2023 Mar 1;19(2):67-70. doi: 10.1097/PTS.0000000000001090. Epub 2023 Jan 12.

Abstract

OBJECTIVES

This study aimed to determine whether potential malpractice events reported by employees, malpractice events involving claims, and malpractice lawsuits differ based on patient race in a large 10-hospital healthcare system.

METHODS

Data in a healthcare system's malpractice database from July 1, 2012, to June 30, 2017, were stratified by patient race using "Black," "White," and "other" categories. χ2 Goodness-of-fit tests were used to compare differences in race proportions in employee-reported observations of events that could lead to payment of a claim, claims not involving the court, and lawsuits involving the court.

RESULTS

There were significantly more employee-reported observations and claims for White patients and significantly fewer observations and claims for Black patients than expected based on the race proportions in the overall healthcare system patient population ( P < 0.001). There were no significant race differences in lawsuits (Black patients, P = 0.146; White patients, P = 0.061; other patients, P = 0.458). Four of the 10 hospitals in the healthcare system had significant race differences in potential malpractice events (hospital A, P < 0.001; hospital B, P = 0.011; hospital E, P < 0.001; hospital G, P = 0.010).

CONCLUSIONS

Our findings reveal the existence of race differences in potential malpractice events in a large healthcare system. By proactively investigating, understanding, and addressing racial disparities in patient safety events, including those recorded in malpractice databases, healthcare systems can help advance initiatives to provide high-quality and equitable care to patients.

摘要

目的

本研究旨在确定在一个大型的 10 家医院医疗保健系统中,员工报告的潜在医疗事故事件、涉及索赔的医疗事故事件和医疗事故诉讼是否因患者种族而异。

方法

使用“黑人”、“白人”和“其他”类别,对医疗保健系统医疗事故数据库中 2012 年 7 月 1 日至 2017 年 6 月 30 日的数据进行分层。采用 χ2 拟合优度检验比较员工报告的可能导致索赔支付的事件观察结果、不涉及法庭的索赔和涉及法庭的诉讼中种族比例的差异。

结果

与整个医疗保健系统患者人群的种族比例相比,白人患者的员工报告观察结果和索赔明显更多,黑人患者的观察结果和索赔明显更少(P<0.001)。在诉讼中,种族差异无统计学意义(黑人患者,P=0.146;白人患者,P=0.061;其他患者,P=0.458)。该医疗保健系统的 10 家医院中有 4 家在潜在医疗事故事件方面存在显著的种族差异(医院 A,P<0.001;医院 B,P=0.011;医院 E,P<0.001;医院 G,P=0.010)。

结论

我们的研究结果表明,在一个大型医疗保健系统中存在潜在医疗事故事件的种族差异。通过积极调查、理解和解决患者安全事件中的种族差异,包括医疗事故数据库中记录的事件,医疗保健系统可以帮助推进为患者提供高质量和公平护理的计划。

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