From the MedStar Health Research Institute, Washington, DC.
J Patient Saf. 2023 Mar 1;19(2):67-70. doi: 10.1097/PTS.0000000000001090. Epub 2023 Jan 12.
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.
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.
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).
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.
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。
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。
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)。
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。