Racial and Ethnic Disparities in Patient Safety

Okoroh, Juliet S.; Uribe, E.; Weingart, Saul N.

doi:10.1097/pts.0000000000000133

Cited by 24 publications

(23 citation statements)

References 25 publications

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“…• There was no significant difference between African Americans and Caucasians for infection rate associated with total hip replacement. Okoroh et al [ 59 ] 2017 US Setting not applicable Systematic review n = 24 Ethnic minorities a) Explore differences in reporting race/ethnicity in studies on disparities in patient safety assess adjustment for socioeconomic status, comorbidity, and disease severity • Eight studies included race/ethnicity in baseline characteristics and adjusted for confounders. • Hospital-level variations were infrequently analysed.…”

Section: Resultsmentioning

confidence: 99%

“…Baehr et al and Okoroh et al in their systematic reviews also noted increased risk of certain ADEs among certain ethnicities for some drugs and contributed these to genetic predisposition and overuse [35,59]. Five systematic reviews concerning adverse events in surgical patients and ADEs were also included [35,37,56,58,59]. In their systematic review and meta-analyses of 26 studies relating to complications and mortality in surgical care, Bloo et al found that ethnic minorities have a higher risk of complications in perioperative care as compared to the ethnic majority patients resulting in a higher incidence of pain and re-operation [37].…”

Section: Review Q 2: What Is the Evidence For Patient Safety Events Imentioning

confidence: 97%

“…The evidence relating to ADEs among ethnic minorities was mixed and was observed to depend on contextual features such as geographical, genetic and cultural features [35,57,59]. Metersky White et al [12] 2012 Australia Primary Focus groups (n = 2) with…”

Section: Review Q 2: What Is the Evidence For Patient Safety Events Imentioning

confidence: 99%

“…The term Asian represented combined Asian/Pacific Islander group but authors did not specify any specific ethnic minority group from Asia. Baehr et al and Okoroh et al in their systematic reviews also noted increased risk of certain ADEs among certain ethnicities for some drugs and contributed these to genetic predisposition and overuse [35,59]. Five systematic reviews concerning adverse events in surgical patients and ADEs were also included [35,37,56,58,59].…”

Section: Review Q 2: What Is the Evidence For Patient Safety Events Imentioning

confidence: 99%

See 3 more Smart Citations

The safety of health care for ethnic minority patients: a systematic review

Chauhan

Walton

Manias

et al. 2020

Int J Equity Health

139

157

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Introduction: Evidence to date indicates that patients from ethnic minority backgrounds may experience disparity in the quality and safety of health care they receive due to a range of socio-cultural factors. Although heightened risk of patient safety events is of key concern, there is a dearth of evidence regarding the nature and rate of patient safety events occurring amongst ethnic minority consumers, which is critical for the development of relevant intervention approaches to enhance the safety of their care. Objectives: To establish how ethnic minority populations are conceptualised in the international literature, and the implications of this in shaping of our findings; the evidence of patient safety events arising among ethnic minority healthcare consumers internationally; and the individual, service and system factors that contribute to unsafe care. Method: A systematic review of five databases (MEDLINE, PUBMED, PsycINFO, EMBASE and CINAHL) were undertaken using subject headings (MeSH) and keywords to identify studies relevant to our objectives. Inclusion criteria were applied independently by two researchers. A narrative synthesis was undertaken due to heterogeneity of the study designs of included studies followed by a study appraisal process. Results: Forty-five studies were included in this review. Findings indicate that: (1) those from ethnic minority backgrounds were conceptualised variably; (2) people from ethnic minority backgrounds had higher rates of hospital acquired infections, complications, adverse drug events and dosing errors when compared to the wider population; and (3) factors including language proficiency, beliefs about illness and treatment, formal and informal interpreter use, consumer engagement, and interactions with health professionals contributed to increased risk of safety events amongst these populations. Conclusion: Ethnic minority consumers may experience inequity in the safety of care and be at higher risk of patient safety events. Health services and systems must consider the individual, inter-and intra-ethnic variations in the nature of safety events to understand the where and how to invest resource to enhance equity in the safety of care. Review registration: This systematic review is registered with Research Registry: reviewregistry761.

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Section: Resultsmentioning

confidence: 99%

Section: Review Q 2: What Is the Evidence For Patient Safety Events Imentioning

confidence: 97%

Section: Review Q 2: What Is the Evidence For Patient Safety Events Imentioning

confidence: 99%

Section: Review Q 2: What Is the Evidence For Patient Safety Events Imentioning

confidence: 99%

See 2 more Smart Citations

The safety of health care for ethnic minority patients: a systematic review

Chauhan

Walton

Manias

et al. 2020

Int J Equity Health

139

157

View full text Add to dashboard Cite

show abstract

“…The 2014 Nation Action Plan has recognized that certain populations might bear a disproportionate burden of ADEs, and it calls for a better understanding of these potential disparities. While other literature reviews have examined racial or ethnic disparities in ADEs, these reviews have been limited by the inclusion of few studies [48] or the focus on a single medication class [49]. To our knowledge, this is the first systematic literature review to examine the state of evidence for racial or ethnic disparities in ADEs, both in general and with particular emphasis on the high-impact drug classes as outlined in the 2014 National Action Plan.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Adverse Drug Events: A Systematic Review of the Literature

Baehr

Peña

2015

J. Racial and Ethnic Health Disparities

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The 2014 National Action Plan for Adverse Drug Event Prevention has recognized adverse drug events (ADEs) as a national priority in order to facilitate a nationwide reduction in patient harms from these events. Throughout this effort, it will be integral to identify populations that may be at particular risk in order to improve care for these patients. We have undertaken a systematic review to evaluate the evidence regarding racial or ethnic disparities in ADEs with particular emphasis on anticoagulants, diabetes agents, and opioids due to the clinical significance and preventability of ADEs associated with these medication classes. From an initial search yielding 3302 studies, we identified 40 eligible studies. Twenty-seven of these included studies demonstrated the presence of a racial or ethnic disparity. There was no consistent evidence for racial or ethnic disparities in the eight studies of ADEs in general. Asians were most frequently determined to be at higher risk of anticoagulant-related ADEs, and black patients were most frequently determined to be at higher risk for diabetes agents-related ADEs. Whites were most frequently identified as at increased risk for opioid-related ADEs. However, few of these studies were specifically designed to evaluate racial or ethnic disparities, lacking a standardized approach to racial/ethnic categorization as well as control for potential confounders. We suggest the need for targeted interventions to reduce ADEs in populations that may be at increased risk, and we suggest strategies for future research.

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Developing a cancer‐specific trigger tool to identify treatment‐related adverse events using administrative data

et al. 2020

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Background As there are few validated tools to identify treatment‐related adverse events across cancer care settings, we sought to develop oncology‐specific “triggers” to flag potential adverse events among cancer patients using claims data. Methods 322 887 adult patients undergoing an initial course of cancer‐directed therapy for breast, colorectal, lung, or prostate cancer from 2008 to 2014 were drawn from a large commercial claims database. We defined 16 oncology‐specific triggers using diagnosis and procedure codes. To distinguish treatment‐related complications from comorbidities, we required a logical and temporal relationship between a treatment and the associated trigger. We tabulated the prevalence of triggers by cancer type and metastatic status during 1‐year of follow‐up, and examined cancer trigger risk factors. Results Cancer‐specific trigger events affected 19% of patients over the initial treatment year. The trigger burden varied by disease and metastatic status, from 6% of patients with nonmetastatic prostate cancer to 41% and 50% of those with metastatic colorectal and lung cancers, respectively. The most prevalent triggers were abnormal serum bicarbonate, blood transfusion, non‐contrast chest CT scan following radiation therapy, and hypoxemia. Among patients with metastatic disease, 10% had one trigger event and 29% had two or more. Triggers were more common among older patients, women, non‐whites, patients with low family incomes, and those without a college education. Conclusions Oncology‐specific triggers offer a promising method for identifying potential patient safety events among patients across cancer care settings.

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Racial and Ethnic Disparities in Patient Safety

Cited by 24 publications

References 25 publications

The safety of health care for ethnic minority patients: a systematic review

The safety of health care for ethnic minority patients: a systematic review

Racial and Ethnic Disparities in Adverse Drug Events: A Systematic Review of the Literature

Developing a cancer‐specific trigger tool to identify treatment‐related adverse events using administrative data

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