(SDAS) Serious Safety Events For Medicaid Children, Implications For MCH Providers
Grantee: Cincinnati Children's Hospital Medical Center
Principal Investigator: Lisa A. Simpson
Project Number: R40MC11279
Project Date: 2/1/2009
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
- Middle Childhood (6-11 years)
- Adolescence (12-18 years)
Abstract
Needs and problems to be addressed: Prior research on pediatric inpatient services reveals significant rates of adverse events and medical errors. Yet there is no national picture of the frequencies, costs, and factors associated with serious safety events in children, using newly-developed pediatric-specific safety indicators. The dearth of national studies, combined with the accelerating trend toward non-reimbursement for safety events makes it imperative to examine the potential impact of these payment policies on the MCH service system and, in particular, on poor and minority children and the hospitals that serve them. Project's relationship to MCHB Strategic Research Issues: This study supports MCHB Strategic Issues I, II and III. By providing information on potentially preventable adverse events in Medicaid children and the related costs to Medicaid, the study will inform policies that affect access to services (Strategic Issue I). In light of known disparities in quality of care, this study will also clarify the extent to which subgroups are at particular risk for adverse events (Strategic Issue II). Finally, by determining factors associated with adverse events and identifying the children most at risk, the study will enable both MCHB and Medicaid policymakers to improve the quality of care for children and adolescents (Strategic Issue III). Proposed dimensions of the study: --Understand factors associated with serious safety events in hospitalized children --Study representative data on a national scale and for a broad range of events --Facilitate a reduction in serious safety events by paving the way to interventions Population group: Hospitalized children under 18, with a focus on Medicaid children Data and sample: This study uses the annual Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality (AHRQ). Our sample will consist of all discharges of children, under age 18 who meet criteria for being at risk and possibly experiencing at least one of 12 measurable and potentially preventable adverse events, as identified by AHRQ's Pediatric Quality Indicator (PDI) software. Discharge- and hospital-level weights allow for national estimates of medical conditions and charges. Costs will be estimated using supplemental cost-to-charge files. Research design and methods: Descriptive statistics of frequencies, mean lengths of stay, and costs associated with potentially preventable complications in hospitalized pediatric patients will be provided for all discharges. We will also present bivariate comparisons for selected subgroups (e.g., children with Medicaid insurance vs. other insurance categories). Multivariate logistic regression will be performed for discharges in the year 2006 in order to estimate the relationship of patient (child), hospital, and area (i.e. county) characteristics with the occurrence of potentially preventable complications at the patient-discharge level. In our analyses, we will examine each adverse event individually and then aggregate the events into a combined (any event) grouping.<< Previous Next >>