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Article
Medicaid Markets and Pediatric Patient Safety in Hospitals
Faculty Publications
  • Richard B. Smith
  • Robyn Cheung
  • Pamela Owens
  • Mark R. Wilson
  • Lisa Simpson
SelectedWorks Author Profiles:

Richard B. Smith

Document Type
Article
Publication Date
2007
Date Issued
October 2007
Date Available
August 2011
Disciplines
Abstract
Objective. To examine the association of Medicaid market characteristics to potentially preventable adverse medical events for hospitalized children, controlling for patient- and hospital-level factors. Data Sources/Study Setting. Two carefully selected Agency for Healthcare Research and Quality (AHRQ) pediatric patient safety indicators (decubitus ulcers and laceration) are analyzed using the new pediatric-specific, risk-adjusting, patient safety algorithm from the AHRQ. All pediatric hospital discharges for patients age 0–17 in Florida, New York, and Wisconsin, and at risk of any of these two patient safety events, are examined for the years 1999–2001 (N5859,922). Study Design. Logistic regression on the relevant pool of discharges estimates the probability an individual patient experiences one of the two PSI events. Data Extraction Methods. Pediatric discharges from the 1999 to 2001 State Inpatient Databases (SIDs) from the AHRQ Healthcare Cost and Utilization Project, merged with hospital-level data from the American Hospital Association’s Annual Survey, Medicaid data obtained from the Centers for Medicare and Medicaid Services and state Medicaid offices, and private and Medicaid managed care enrollment data obtained from Inter- Study, are used in the estimations. Principal Findings. At the market level, patients in markets in which Medicaid payers face relatively little competition are more likely to experience a patient safety event (odds ratio [OR]51.602), while patients in markets in which hospitals face relatively little competition are less likely to experience an adverse event (OR50.686). At the patient-discharge and hospital levels, Medicaid characteristics are not significantly associated with the incidence of a pediatric patient safety event. Conclusions. Our analysis offers additional insights to previous work and suggests a new factor——the Medicaid-payer market——as relevant to the issue of pediatric patient safety.
Comments
Abstract only. Full-text article is available only through licensed access provided by the publisher. Published in Health Services Research, 42(5), 1981-1998. DOI: 10.1111/j.1475-6773.2007.00698.x Members of the USF System may access the full-text of the article through the authenticated link provided.
Language
en_US
Publisher
Blackwell
Creative Commons License
Creative Commons Attribution-Noncommercial-No Derivative Works 4.0
Citation Information
Smith, Richard B.; Cheung, Robyn; Owens, Pamela; Wilson, R. Mark; Simpson, Lisa.Health Services Research, Oct2007, Vol. 42 Issue 5, p1981-1998