Hospital-reported medical errors in children.
BACKGROUND
Medical errors are an important problem for hospitalized adult inpatients. However, medical errors in children remain comparatively understudied, and published research has been relatively limited.


OBJECTIVE
To investigate the national rates of hospital-reported medical errors in pediatric inpatients over the period 1988-1997; and to determine the association of patient and hospital characteristics with the occurrence of hospital-reported medical errors in children.


METHODS
A nonconcurrent cohort study of hospitalized nonnewborn pediatric patients in the United States <or=18 years of age. Data from the Healthcare Cost and Utilization Project for the years 1988, 1991, 1994, and 1997 were used for these analyses.


METHODS
The occurrence of hospital-reported medical errors.


RESULTS
The national rate of hospital-reported medical errors in hospitalized children ranged from 1.81 to 2.96 per 100 discharges. These medical error rates were statistically lower in 1988, with the years 1991, 1994, and 1997 not being statistically different from each other. There were no consistent differences in the rates of medical errors when stratified by gender, race, payor status, or median household income of the patient's zip code across years. There was, however, a statistically significant relationship between higher median household income and increasing medical error rates; this trend was consistent across all 4 years. Similarly, children with special medical needs or dependence on a medical technology also had significantly higher rates of hospital-reported medical errors. Although hospital size did not seem to be related to the rate of medical errors, private for-profit hospitals consistently reported lower rates, whereas urban teaching hospitals in all years but 1997 reported higher rates of medical errors.


CONCLUSIONS
These data highlight both the strengths and limitations of administrative data in the investigation of medical errors. Substantively, they suggest fruitful areas for additional and more detailed study, notably children with special medical needs.
Slonim
Anthony D
AD
Center for Health Services and Clinical Research, Children's Research Institute, Children's National Medical Center, Washington, DC 20010, USA. aslonim@cnmc.org
LaFleur
Bonnie J
BJ
Ahmed
Wendy
W
Joseph
Jill G
JG
D000293:Adolescent; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D019300:Medical Errors / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D009026:Mortality; D017063:Outcome Assessment, Health Care; D010372:Pediatrics / Q000706:statistics & numerical data* / Q000639:trends; D014481:United States / Q000453:epidemiology