Racial disparities in clinic follow-up early in life among survivors of congenital heart disease
| Autor: | Millie Harris, Jennifer DeSalvo, Jamie L. Jackson, Curt J. Daniels, Deena J. Chisolm, Jennifer Morack |
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| Rok vydání: | 2018 |
| Předmět: |
Heart Defects
Congenital Male Pediatrics medicine.medical_specialty Heart disease Insurance type 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Surveys and Questionnaires Prevalence Medicine Humans Radiology Nuclear Medicine and imaging Survivors Medical diagnosis Prospective cohort study Child Ohio Retrospective Studies business.industry Incidence Racial Groups Age Factors Infant Newborn Infant General Medicine Cardiology clinic medicine.disease Hospitals Pediatric Cardiac surgery Increased risk Child Preschool Pediatrics Perinatology and Child Health Surgery Female Cardiology and Cardiovascular Medicine business Medicaid Follow-Up Studies |
| Zdroj: | Congenital heart disease. 14(2) |
| ISSN: | 1747-0803 |
| Popis: | Objective The current study aims to identify the rates of lapses in care and loss to follow-up before age one through age five for white and nonwhite congenital heart disease (CHD) survivors. Nonwhite CHD survivors were hypothesized to experience an earlier lapse in care and be lost to follow-up than whites. Design Patients were from a large pediatric hospital and had (1) at least one outpatient cardiology clinic visit or cardiac surgery visit before the age of one and (2) a diagnosis of moderate or complex structural CHD. Cardiology outpatient utilization rates were tracked from before age one through age five. Lapse in follow-up was defined as not having at least one outpatient cardiology visit per year, and loss to follow-up was not returning after a lapse in care by age five. Race was categorized as white and nonwhite. Covariates included sex, insurance type, noncardiology inpatient and outpatient hospital utilization, and CHD severity. Results The sample included 1034 patients. Overall, 75.7% experienced a lapse in care with only 41.6% of those returning by age five. Nonwhites experienced lapses in care at younger ages than whites. Nonwhites had a 53% increased risk of lapse in care. Medicaid patients and those with moderate CHD diagnoses also had an increased risk for lapse in care. Conclusions Lapse in care appears prevalent among CHD survivors by age five, with nonwhites demonstrating elevated risk. Future multisite prospective studies should include the assessment of parental knowledge, barriers to accessing care, and satisfaction with care. |
| Databáze: | OpenAIRE |
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