Details

Autor(en) / Beteiligte

• Dickens, Harrison
• Rao, Uma
• Sarver, Dustin
• Bruehl, Stephen
• Kinney, Kerry
• Karlson, Cynthia
• Grenn, Emily
• Kutcher, Matthew
• Iwuchukwu, Chinenye
• Kyle, Amber
• Goodin, Burel
• Myers, Hector
• Nag, Subodh
• Hillegass, William B.
• Morris, Matthew C.

Titel

Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care

Ist Teil von

• Journal of racial and ethnic health disparities, 2023-06, Vol.10 (3), p.1006-1017

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2023

Quelle

Applied Social Sciences Index & Abstracts (ASSIA)

Beschreibungen/Notizen

• Background Disparities in trauma outcomes and care are well established for adults, but the extent to which similar disparities are observed in pediatric trauma patients requires further investigation. The objective of this study was to evaluate the unique contributions of social determinants (race, gender, insurance status, community distress, rurality/urbanicity) on trauma outcomes after controlling for specific injury-related risk factors. Study Design All pediatric (age < 18) trauma patients admitted to a single level 1 trauma center with a statewide, largely rural, catchment area from January 2010 to December 2020 were retrospectively reviewed ( n  = 14,398). Primary outcomes were receipt of opioids in the emergency department, post-discharge rehabilitation referrals, and mortality. Multivariate logistic regressions evaluated demographic, socioeconomic, and injury characteristics. Multilevel logistic regressions evaluated area-level indicators, which were derived from abstracted home addresses. Results Analyses adjusting for demographic and injury characteristics revealed that Black children (n = 6255) had significantly lower odds ( OR  = 0.87) of being prescribed opioid medications in the emergency department compared to White children ( n  = 5883). Children living in more distressed and rural communities had greater odds of receiving opioid medications. Girls had significantly lower odds ( OR  = 0.61) of being referred for rehabilitation services than boys. Post hoc analyses revealed that Black girls had the lowest odds of receiving rehabilitation referrals compared to Black boys and White children. Conclusion Results highlight the need to examine both main and interactive effects of social determinants on trauma care and outcomes. Findings reinforce and expand into the pediatric population the growing notion that traumatic injury care is not immune to disparities.