Factors Associated With Likelihood of Experiencing a Pediatric Safety Event in the Inpatient Setting.

OBJECTIVE: Adult studies show that persons marginalized by race/ethnicity, preferred language, and public insurance experience higher rates of hospital harm. This study examined the association between patient race/ethnicity, preferred language, insurance type, and safety events among hospitalized pediatric patients. METHODS: This retrospective observational study analyzed safety event reports from 2 tertiary children's hospitals (2020-2022). Patients ≤18 years admitted to neonatal intensive care, pediatric intensive care, and inpatient units were included. Demographics were obtained from the electronic health record, and safety events from the voluntary reporting system. Patients were matched by age, sex, and unit to reduce confounding. Descriptive statistics and multivariable logistic regression were used to assess the independent effect of demographic factors on the occurrence of safety events. RESULTS: Among 4112 unique patients, 370 (9%) experienced a reported safety event. Medication errors comprised 76% of events. After matching, there were no statistically significant differences in the likelihood of experiencing a safety event by race/ethnicity or primary language. However, patients with public insurance had higher odds of experiencing a safety event than those with private insurance (OR=1.51; 95% CI: 1.04-2.20). CONCLUSION: Public insurance type remains a significant factor in a patient's likelihood of experiencing a safety event during hospitalization. While previous studies have identified race/ethnicity and primary language as contributing factors, we observed no such associations in our analysis. Further research is warranted to explore the underlying structural drivers of this health inequity.