Racial/ethnic differences in receipt of surgery among children in the United States.

Autor: Sanford EL; Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, TX, USA; Department of Pediatric Critical Care, University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, Texas, USA; Outcomes Research Consortium, Cleveland, OH, USA. Electronic address: Ethan.Sanford@utsouthwestern.edu., Nair R; Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA., Alder A; Department of Pediatric Surgery, University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, TX, USA., Sessler DI; Outcomes Research Consortium, Cleveland, OH, USA; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA., Flores G; Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA; Holtz Children's Hospital, Jackson Health System, Miami, FL, USA., Szmuk P; Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, TX, USA; Outcomes Research Consortium, Cleveland, OH, USA.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2022 Dec; Vol. 57 (12), pp. 852-859. Date of Electronic Publication: 2022 Apr 12.
DOI: 10.1016/j.jpedsurg.2022.03.035
Abstrakt: Background: It is unknown whether racial/ethnic disparities exist in surgical utilization for children. The aim, therefore, was to evaluate the odds of surgery among children in the US by race/ethnicity to test the hypothesis that minority children have less surgery.
Methods: Cross-sectional data were analyzed on children 0-18 years old from the 1999 to 2018 National Health Interview Survey, a large, nationally representative survey. The primary outcome was odds of surgery in the prior 12 months for non Latino African-American, Asian, and Latino children, compared with non Latino White children, after adjustment for relevant covariates. The National Surgical Quality Improvement Program Pediatric Dataset was used to analyze the odds of emergent/urgent surgery by race/ethnicity.
Results: Data for 219,098 children were analyzed, of whom 10,644 (4.9%) received surgery. After adjustment for relevant covariates, African-American (AOR, 0.54; 95% CI, 0.50-0.59), Asian (AOR, 0.39; 95% CI, 0.33-0.46), and Latino (AOR, 0.62; 95% CI, 0.57-0.67) children had lower odds of surgery than White children. Latino children were more likely to require emergent or urgent surgery (AOR, 1.71; 95% CI, 1.68-1.74).
Conclusions: Latino, African-American, and Asian children have significantly lower adjusted odds of having surgery than White children in America, and Latino children were more likely to have emergent or urgent surgery. These racial/ethnic differences in surgery may reflect disparities in healthcare access which should be addressed through further research, ongoing monitoring, targeted interventions, and quality-improvement efforts.
Level of Evidence: II.
Type of Study: Prognosis study.
Competing Interests: Declaration of Competing Interest None.
(Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: