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Medical errors affect 2 to 3 of every 100 children discharged from the hospital. Errors are more common among children with special medical needs and those who are dependent on a medical technology, according to a study supported in part by the Agency for Healthcare Research and Quality (HS11022). These more seriously ill children are usually hospitalized longer and undergo more medical procedures, both of which increase their likelihood of being affected by errors, suggests Anthony Slonim, M.D., of Children's National Medical Center.
Dr. Slonim and his colleagues used data from the Healthcare Cost and Utilization Project for the years 1988, 1991, 1994, and 1997, which profiled discharges from a sample of community hospitals in over 20 States. They calculated hospital-reported medical errors among nonnewborn pediatric inpatients up to 18 years of age.
The national rate of hospital-reported medical errors (ranging from procedural complications from implanting of grafts or devices to drug errors) in hospitalized children ranged from 1.81 to 2.96 per 100 discharges. The error rate increased from 1988 to 1991 but remained stable from 1991 to 1997. Procedural complications were more common in 1991 and 1997 than in 1988, but drug-related errors showed a significant decreasing trend over the 4 years studied.
Children who remained hospitalized for more than 5 days had a higher rate of errors in all of the years studied. The mean length of hospital stay was two to three times higher and death rates were four to five times higher for medical error patients than for those patients who did not experience medical errors across all years studied. Hospital size did not seem to be related to the rate of medical errors. However, private for-profit hospitals consistently reported lower error rates, while urban teaching hospitals in all years but 1997 reported higher medical error rates than other hospitals.
See "Hospital-reported medical errors in children," by Dr. Slonim, Bonnie J. LaFleur, Ph.D., Wendy Ahmed, B.S., and Jill G. Joseph, M.D., Ph.D., in the March 2003 Pediatrics 111(3), p. 617-621.
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