Racial and socioeconomic disparities in outcomes following pediatric cerebrospinal fluid shunt procedures

被引:67
作者
Attenello, Frank J. [1 ]
Ng, Alvin [2 ]
Wen, Timothy [6 ]
Cen, Steven Y. [3 ,4 ]
Sanossian, Nerses [3 ]
Amar, Arun P. [1 ]
Zada, Gabriel [1 ]
Krieger, Mark D. [1 ,5 ]
McComb, J. Gordon [1 ,5 ]
Mack, William J. [1 ]
机构
[1] Univ So Calif, Keck Sch Med, Dept Neurosurg, Los Angeles, CA 90033 USA
[2] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90033 USA
[3] Univ So Calif, Keck Sch Med, Dept Neurol, Los Angeles, CA 90033 USA
[4] Univ So Calif, Keck Sch Med, Dept Radiol, Los Angeles, CA 90033 USA
[5] Univ So Calif, Childrens Hosp Los Angeles, Div Neurosurg, Los Angeles, CA USA
[6] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA
关键词
hydrocephalus; neurosurgery; outcomes; inpatient death; routine discharge; ETHNIC DISPARITIES; UNITED-STATES; HEALTH-CARE; CHILDREN; RACE; INSURANCE; GENDER; ACCESS; STROKE;
D O I
10.3171/2014.11.PEDS14451
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECT Racial and socioeconomic disparities within the US health care system are a growing concern. Despite extensive research and efforts to narrow such disparities, minorities and economically disadvantaged patients continue to exhibit inferior health care outcomes. Disparities in the delivery of pediatric neurosurgical care are understudied. Authors of this study examine the impact of race and socioeconomic status on outcomes following pediatric CSF shunting procedures. METHODS Discharge information from the 2000, 2003, 2006, and 2009 Kids' Inpatient Database for individuals (age < 21 years) with a diagnosis of hydrocephalus who had undergone CSF shunting procedures was abstracted for analysis. Multivariate logistic regression analyses, adjusting for patient and hospital factors and annual CSF shunt procedure volume, were performed to evaluate the effects of race and payer status on the likelihood of inpatient mortality and nonroutine hospital discharge (that is, not to home). RESULTS African American patients (p < 0.05) had an increased likelihood of inpatient death and nonroutine discharge compared with white patients. Furthermore, Medicaid patients had a significantly higher likelihood of nonroutine discharge (p < 0.05) as compared with privately insured patients. CONCLUSIONS Findings in this study, which utilized US population-level data, suggest the presence of racial and socioeconomic status outcome disparities following pediatric CSF shunting procedures. Further studies on health disparities in this population are warranted.
引用
收藏
页码:560 / 566
页数:7
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