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Angela D. Thomas, DrPH, MPH, MBA, presented at a roundtable discussion at the American Public Health Association 2017 Annual Meeting & Expo. Her research investigated potential differences in reported harmful patient safety events among vulnerable populations in a large healthcare system. Dr. Thomas is the Executive Director of the MedStar Health Services Research Network.
“Differences in reported harmful patient safety events in vulnerable populations” sought to identify differences reported harmful events in a Patient Safety Event Management System (PSEMS) in relation to the race, ethnicity, insurance, and language of patients included in the electronic medical record.
Previous research has shown that there are disparities in quality of care due to racial and ethnic disparities and that these differences remain after controlling for social factors such as income and education. This research sought to increase our knowledge, as disparities in health outcomes are widely documented but little is known about disparities in patient safety events.
The retrospective analysis focused on MedStar’s ten-hospital system and used race as the key independent variable, which was grouped as black, white or other, excluding patients who were listed as unknown or if race data was missing. Other variables included language (English, Other, Unknown), ethnicity (Hispanic, Non-Hispanic, Unknown) and insurance (Medicare, Medicaid, Commercial, Self-pay, Other). The research compared the proportions of vulnerable populations in the PSEMS cohort to the healthcare system cohort.
The research found that there were no notable differences by ethnicity or language. There was a high rate of reported safety events in those patients who are part of Medicaid and/or Medicare. By race, the research found that there were higher proportions of whites in PSEMS than expected, with lower proportions of “Other” (non-Black) minorities. All results were significant at p<.001. Out of the ten hospitals, three had lower proportions of Black patients in PSEMS than expected, and one hospital had a higher proportion of Black patients in PSEMS.
The research concluded that while white patients typically had higher event reporting, race differences emerge by location. Further research will need to be done to determine if there may be an actual disparity in harmful events for some Black, low income, and elderly patients. In addition, there may also be an underreporting of harmful events for minority patients in some settings.
[Editor’s note: This research was conducted as part of Dr. Thomas’ dissertation and we wish to congratulate her on her recent doctor of public health!]
