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Acute Care/Hospitalization

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Medical injuries among children result in longer hospital stays and higher charges

According to a new study, researchers from the Medical College of Wisconsin identified that 3.4 percent of children hospitalized in Wisconsin between 2000 and 2002 suffered a medical injury. These injuries were due to problems with medications (1.5 percent), procedures (1.3 percent), and medical devices (0.9 percent). Injured children had a half day (12 percent) longer hospital stay and $1,614 (26 percent) higher charges than children without medical injuries. Hospitals and pediatricians should focus on medications, procedures, and devices most associated with pediatric medical injuries to improve patient safety, suggest the authors of the study.

Investigators used Wisconsin Medical Injury Prevention Program (WMIPP) screening criteria to identify medical injuries among 318,785 children admitted to one of 134 Wisconsin hospitals between 2000 and 2002. The WMIPP differs from the Patient Safety Indicators (PSIs) developed by the Agency for Healthcare Research and Quality (AHRQ) in that it identifies injuries that occur in the hospital. It also identifies those that occur in the outpatient, community, and home settings that can lead to the child's hospitalization, such as an acetaminophen overdose at home.

The results were generally consistent with previous PSI findings up to 2000. Analysis of hospital discharge records showed that excess length of stay and charges were greatest for injuries due to genitourinary devices/implants, vascular devices, and infections/inflammation after procedures. Public health leaders can use this information to prioritize areas for outpatient or community interventions. Since the WMIPP data are based on hospital discharge data, they cannot include great clinical detail. This approach is also limited by variability among states in coding of external cause of injury in hospital discharge data. The study was supported in part by AHRQ (HS11893).

More details are in "Medical injuries among hospitalized children," by John R. Meurer, M.D., M.B.A., Hongyan Yang, Ph.D., Clare E. Guse, M.S., and others in the June 2006 Quality and Safety in Health Care 15, pp. 202-207.

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