Association Between Language, Serious Adverse Events, and Length of Stay Among Hospitalized Children

Details

• Personal Author:
  Brownstein D ; Ebel BE ; Lion KC ; Michel E ; Rafton SA ; Shafii J ; Tolman M
• Description:
  Objective: To evaluate the risk for serious/sentinel adverse events among hospitalized children according to race, ethnicity, and language and to evaluate factors affecting length of stay associated with serious/sentinel adverse events. Methods: We conducted a retrospective cohort study of all pediatric inpatients at a large children's hospital from October 2007 to October 2009. We evaluated the relationship between self-reported race, ethnicity, and primary language; with having a serious or sentinel adverse event, defined as an unexpected occurrence involving risk of death or serious injury; or a potentially harmful event resulting from nonstandard practice. We also examined length of stay. Clinical complexity was adjusted for by using Clinical Risk Groups. Results: Of 33 885 patients, 8% spoke Spanish and 4% spoke other languages. Serious and sentinel events were rare; however, among patients with such events, 14% spoke Spanish. Adjusting for potential confounders, Spanish speakers trended toward an elevated odds of adverse event (odds ratio: 1.83 [95% confidence interval: 0.98-3.39]). Controlling for age, language, and clinical complexity, having an adverse event was associated with a nearly fivefold increase in length of stay (95% confidence interval: 3.87-6.12). Spanish-speaking patients with an adverse event were hospitalized significantly longer than comparable English speakers (26 vs 12.7 days; P = .03 for interaction between language and adverse event). Conclusions: Hospitalized children from Spanish-speaking families had significantly longer hospital stays in association with an adverse event and may have increased odds of a serious or sentinel event. These findings suggest that an important component of patient safety may be to address communication barriers. [Description provided by NIOSH]
• Subjects:
  Communication Healthcare Disparities Health Personnel Health Promotion Occupational Health Safety
• Keywords:
  Author Keywords: Adverse Events Children Communication Barriers Communication Research Health Care Disparities Health Communications Health Disparities Hospitalized Child Language Barrier Medical Errors Physicians

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• ISSN:
  2154-1663
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  219-225
• Volume:
  3
• Issue:
  3
• NIOSHTIC Number:
  nn:20056846
• Citation:
  Hosp Pediatr 2013 Jul; 3(3):219-225
• Contact Point Address:
  Dr. Lion, University of Washington Center for Child Health, Behavior and Development, Seattle Children's Research Institute, M/S CW8-6 PO Box 5371, Seattle, WA 98145-5005
• Email:
  casey.lion@seattlechildrens.org
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Hospital Pediatrics
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:587694d3856060817a0f75e5f0b47d0cc67da245cd05a55d508096e0a206b3a062e4ac0db4d4b63faf230d6f588b5987ca2442ba7be06e27207620d2bb44f955
• Download URL:
  https://stacks.cdc.gov/view/cdc/214345/cdc_214345_DS1.pdf
• File Type:
  [PDF - 519.75 KB ]