Racial Disparities in Health Care Resource Utilization After Pediatric Cervical and/or Thoracic Spinal Injuries

被引:0
作者
Elsamadicy, Aladine A. [1 ]
Sandhu, Mani R. [1 ]
Freedman, Isaac G. [1 ]
Koo, Andrew B. [1 ]
Hengartner, Astrid C. [1 ]
Reeves, Benjamin C. [1 ]
Havlik, John [1 ]
Sarkozy, Margot [1 ]
Hong, Chris S. [1 ]
Kundishora, Adam J. [1 ]
Tuason, Dominick A. [2 ]
DiLuna, Michael [1 ]
机构
[1] Yale Univ, Sch Med, Dept Neurosurg, New Haven, CT 06510 USA
[2] Yale Univ, Dept Orthoped, Sch Med, New Haven, CT USA
关键词
Healthcare utilization; Pediatric trauma; Racial disparity; Race; Spinal injury; LENGTH-OF-STAY; CORD-INJURY; OUTCOMES; CHILDREN; BRAIN; COMPLICATIONS; EPIDEMIOLOGY; INSURANCE;
D O I
10.1016/J.WNEU.2021.09.047
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: This study aimed to investigate the impact of race on hospital length of stay (LOS) and hospital complications among pediatric patients with cervical/thoracic injury. METHODS: A retrospective cohort was performed using the 2017 admission year from 753 facilities utilizing the National Trauma Data Bank. All pediatric patients with cervical/thoracic spine injuries were identified using the ICD-10-CM diagnosis coding system. These patients were segregated by their race, non-Hispanic white (NHW), non Hispanic black (NHB), non-Hispanic Asian (NHA), and Hispanic (H). Demographic, hospital variable, hospital complications, and LOS data were collected. A linear and logistic multivariate regression analysis was performed to determine the risk ratio for hospital LOS as well as complication rate, respectively. RESULTS: A total of 4,125 pediatric patients were identified. NHB cohort had a greater prevalence of cervical-only injuries (NHW: 37.39% vs. NHB: 49.93% vs. NHA: 34.29% vs. H: 38.71%, P < 0.001). While transport accident was most common injury etiology for both cohorts, NHB cohort had a greater prevalence of assault (NHW: 1.53% vs. NHB: 17.40% vs. NHA: 2.86% vs. H: 6.58%, P < 0.001) than the other cohorts. Overall complication rates were significantly higher among NHB patients (NHW: 9.39% vs. NHB: 15.12% vs. NHA: 14.29% vs. H: 13.60%, P < 0.001). Compared with the NHW cohort, NHB, NHA, and H had significantly longer hospital LOS (NHW: 6.15 +/- 9.03 days vs. NHB: 9.24 +/- 20.78 days vs. NHA: 9.09 +/- 13.28 days vs. H: 8.05 +/- 11.45 days, P < 0.001). NHB race was identified as a significant predictor of increased LOS on multivariate regression analysis (risk ratio: 1.14, 95% confidence interval: 0.46, 1.82; P = 0.001) but not hospital complications (P = 0.345). CONCLUSIONS: Race may significantly impact health care resource utilization following pediatric cervical/ thoracic spinal trauma.
引用
收藏
页码:E307 / E318
页数:12
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