More hospital errors when kids have chronic ills

NEW YORK Tue Sep 11, 2012 1:23pm EDT

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NEW YORK (Reuters Health) - Medical errors affect about three percent of hospitalized children in the U.S., with the risk being higher if they have a chronic health condition, a new study suggests.

Using a government database, researchers found that of children hospitalized in 38 U.S. states in 2006, 44 percent had at least one chronic health problem, such as asthma, a digestive disorder, diabetes or cancer.

Among hospitalized kids with no chronic health problems, 1.3 percent were affected by a medical error; the figure among children with a chronic condition was just over five percent.

The results, reported in the journal Pediatrics, are not surprising, the researchers say. In fact, they expected to see a higher error rate among kids with chronic disorders.

"They may stay in the hospital longer, and their condition may be more complicated" compared with kids free of chronic ills, explained senior researcher Dr. Huiyun Xiang, of Nationwide Children's Hospital in Columbus, Ohio.

It's not clear from the findings how serious the medical errors were, or how often they caused kids harm. The errors were not even necessarily "mistakes," per se, Xiang said.

The researchers used hospital discharge records and counted certain "codes" as a medical error. That included codes like "complications peculiar to certain specified procedures."

Adverse reactions to a medication, an infection following surgery and even bedsores are more general examples of the kinds of potentially preventable events considered medical errors.

The bottom line, according to the researchers, is that everyone needs to be aware of the greater error risk when kids have chronic health problems.

And the risk appears to climb in tandem with the number of conditions a child has. Among kids with one chronic ill, the error rate was around three percent, while for those with two the rate was closer to seven percent.

For parents, Xiang said the risk of medical error should be kept in context. "Even the overall rate of 5.3 percent among children with chronic conditions is relatively low," he noted.

This study did not look at potential fixes, Xiang said. But he noted that the federal Agency for Healthcare Research and Quality (AHRQ) has been funding projects to improve hospital patients' safety - like preventing infections, which are the most common complication of hospital stays nationwide.

Those efforts stemmed largely from a 1999 report by the Institute of Medicine (IOM), which found that medical errors cost the U.S. $17 billion to $29 billion a year - and kill nearly 98,000 people.

The IOM said that many errors arise because the healthcare system is "fragmented," and stressed that improving safety needs to be a "team sport."

AHRQ suggests that hospital patients, or parents of patients, help protect themselves by asking questions. One step is to make sure that someone - like your pediatrician - is coordinating your child's care and making sure everyone is on the same page.

Xiang also said it's important for parents to understand their child's at-home medication regimen, especially if there are multiple health conditions.

"Parents should be very careful in monitoring their child's medication at home," he said.

Xiang pointed to a recent study in which researchers made home visits to families of children with sickle cell disease or epilepsy. Looking at 280 medication uses, they found 61 errors - like giving the child the wrong dose, or missing a dose altogether.

SOURCE: bit.ly/S4kiB8 Pediatrics, online September 10, 2012.

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