Children hospitalized with chronic medical conditions are more likely to be affected by medical errors than those who are hospitalized but don’t have a chronic condition, according to researchers.
The medical error rate per 100 hospital discharges was 5.3% (95% CI: 4.9–5.7) among children with a chronic medical condition vs. 1.3% (95% CI: 1.2–1.3) in children without a chronic condition, Namrata Ahuja, MD, of the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, and colleagues reported in Pediatrics.
As many as 43% of U.S. children have at least one chronic health condition, according to background information in the study, comprising an increasing proportion of children who are hospitalized. Yet no national studies to date analyzed the frequency of medical errors in this population.
So Ahuja and colleagues analyzed the association between chronic conditions and iatrogenic medical errors among a cohort of hospitalized U.S. children from 38 states, who were included in the 2006 Kids’ Inpatient Database (KID) — the only national data set designed to study children’s use of hospital services.
Overall, 22.3% of pediatric inpatients had at least chronic condition, 9.8% had two chronic conditions, and 12.% had 3 or more chronic conditions. A total of 44% of the children had at least one chronic condition such as asthma, diabetes or cancer.
The overall medical error rate was 3% in all pediatric patients (95% CI: 2.8–3.3) included in the study, and 1.3% in patients with no chronic conditions, but jumped to 5.3% among those with chronic conditions. This association between chronic conditions and medical errors remained statistically significant, even after adjusting for patient characteristics, hospital characteristics, disease severity and length of stay,
Furthermore, the likelihood of a medical error occurring increased with the number of chronic conditions a given patient had. In an adjusted logicistic regression model the odds ratio of medical errors for children with one chronic condition was 1.40 (95% CI: 1.32–1.48) and increased to 1.55 (95% CI: 1.45–1.66) among those with two conditions and 1.66 (95% CI: 1.53–1.81) for children with three conditions.
The reason for higher medical error rates among these children may be because those with more health issues in the first place are staying in the hospital longer, and may more complicated treatments, the researchers noted. Errors were not necessarily mistakes per se, and included things like adverse reactions to medications, infections following surgery and pressure ulcers.
While the study did not look at possible solutions for the problem, the researchers noted that the Agency for Healthcare Research and Quality has been funding projects to improve hospital safety and reduce common complications such as infections.
“Clinicians need to be cognizant of these risks when treating pediatric patients with chronic conditions, and future studies need to be conducted to corroborate or refute the findings reported here,” the researchers wrote.