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A prospective mixed methods cohort study to assess ethnic inequities in patient safety in Dutch hospital care.

Rosse, F. van, Bruijne, M. de, Stronks, K., Wagner, C., Essink-Bot, M.L. A prospective mixed methods cohort study to assess ethnic inequities in patient safety in Dutch hospital care. Journal of Epidemiology and Community Health: 2011, 65(Suppl. 1), p. A168-169. Abstract. IEA World Congress of Epidemiology, 7-11 August 2011, Edinburgh.
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Introduction: USA studies showed an increased risk of patient safety incidents in hospital care among ethnic minorities, but in Europe ethnic disparities in patient safety have never been analysed. The present study aims to 1. Assess the risk of patient safety events in patients of non-western ethnic origin in comparison to Dutch patients 2. Analyse the determinants of the risk of adverse events in patients of non-western origin, and 3. Explore causal mechanisms in patient-provider interaction. Methods: Prospective mixed methods cohort study in four hospitals. In total, 2000 patients (1000 Dutch, 1000 of any non-Western ethnic origin, age range:45–75 years) will be included. Data on explanatory variables (eg, Dutch language proficiency, health literacy, education, religion) are collected at admission. After discharge, a two-stage medical record review study, based on a Dutch record review study, is conducted by experienced reviewers to determine the incidence of adverse events. Determinants will be analysed by multilevel multivariable stepwise logistic regression. Mechanisms in the care process will be explored in qualitative interviews with patients and providers. Results: Recruitment has started in December, 2010 and will continue for 24 months. Presently, 50 patients were recruited. By August, preliminary data and practical lessons from data collection will be available. Conclusion: The study will quantify the risk of patient safety incidents among ethnic minority patients in hospital care, unravel the causes, and identify policy opportunities to minimise inequities in care. (aut. ref.)