title: Racial disparities in the frequency of patient safety events: results from the National Medicare Patient Safety Monitoring System.
abstract: BACKGROUND
  Although there is extensive evidence of racial disparities in processes and outcomes of medical care, there has been limited investigation of disparities in patient safety.
  
  
  OBJECTIVE
  To determine whether there are racial disparities in the frequency of adverse events studied in the Medicare Patient Safety Monitoring System.
  
  
  METHODS
  Abstraction of 102,623 randomly selected charts from hospital discharges of non-Hispanic white and black Medicare patients between January 1, 2004 and December 31, 2007 to assess frequency of patient safety events in 4 domains: general (pressure ulcers and falls), selected nosocomial infections, selected procedure-related adverse events, and adverse drug events due to anticoagulants and hypoglycemic agents.
  
  
  METHODS
  Racial disparities in risk of patient safety events, and differences in adverse event rates among hospital groups stratified by percentage of black patients.
  
  
  RESULTS
  Blacks had higher adjusted risk than whites of suffering one of the measured nosocomial infections (1.34; 95% confidence interval, 1.17-1.55; P < 0.001) and one of the measured adverse drug events (1.29; 95% confidence interval, 1.19-1.40; P < 0.001). After adjustment for patient and hospital factors, patients in hospitals with the highest percentages of black patients were at increased risk of experiencing one of the measured nosocomial infections (1.9% vs. 1.5%; P < 0.001) and adverse drug events (8.7% vs. 7.8%; P < 0.01).
  
  
  CONCLUSIONS
  Hospitalized blacks are at higher risk than whites of experiencing certain patient safety events. In addition, hospitals serving high percentages of black patients have higher risk-adjusted rates of selected patient safety events.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, CT 06030-1225, USA. Metersky@nso.uchc.edu
authors.forename: Mark L
authors.initials: ML
authors.lastname: Metersky
authors.forename: David R
authors.initials: DR
authors.lastname: Hunt
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kliman
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
authors.forename: Maureen
authors.initials: M
authors.lastname: Curry
authors.forename: Nancy
authors.initials: N
authors.lastname: Verzier
authors.forename: Courtney H
authors.initials: CH
authors.lastname: Lyder
authors.forename: Ernest
authors.initials: E
authors.lastname: Moy
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D044383:Black People / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D008297:Male; D006278:Medicare / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data*; D012449:Safety / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
chemical_list: D000925:Anticoagulants; D007004:Hypoglycemic Agents