Leaving the emergency department without complete care: disparities in American Indian children
Abstract Background Children who leave the emergency department (ED) without complete evaluation or care (LWCET) have poorer outcomes in general. Previous studies have found that American Indian (AI) children have higher rates of LWCET than other racial or ethnic groups. Therefore, this study aims t...
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3092-z |
| _version_ | 1818127531727912960 |
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| author | Tess L. Weber Katherine M. Ziegler Anupam B. Kharbanda Nathaniel R. Payne Chad Birger Susan E. Puumala |
| author_facet | Tess L. Weber Katherine M. Ziegler Anupam B. Kharbanda Nathaniel R. Payne Chad Birger Susan E. Puumala |
| author_sort | Tess L. Weber |
| collection | DOAJ |
| description | Abstract Background Children who leave the emergency department (ED) without complete evaluation or care (LWCET) have poorer outcomes in general. Previous studies have found that American Indian (AI) children have higher rates of LWCET than other racial or ethnic groups. Therefore, this study aims to examine LWCET in AI children by exploring differences by ED location and utilization patterns. Methods This is a retrospective cohort study of five EDs in the upper Midwest between June 2011 and May 2012. We included all visits by children aged 0–17 who identified as African American (AA), AI or White. Logistic regression was used to determine differences in LWCET by race and ED location controlling for other possible confounding factors including sex, age, insurance type, triage level, distance from ED, timing of visit, and ED activity level. Results LWCET occurred in 1.73% of 68,461 visits made by 47,228 children. The multivariate model revealed that AIs were more likely to LWCET compared to White children (Odds Ratio (OR) = 1.62, 95% Confidence Interval (CI) = 1.30–2.03). There was no significant difference in LWCET between AA and White children. Other factors significantly associated with LWCET included triage level, distance from the ED, timing of visit, and ED activity level. Conclusion Our results show that AI children have higher rates of LWCET compared to White children; this association is different from other racial minority groups. There are likely complex factors affecting LWCET in AI children throughout the upper Midwest, which necessitates further exploration. |
| first_indexed | 2024-12-11T07:18:50Z |
| format | Article |
| id | doaj.art-58318738aa5a41a9a40de8384734ded1 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T07:18:50Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-58318738aa5a41a9a40de8384734ded12022-12-22T01:16:09ZengBMCBMC Health Services Research1472-69632018-04-011811610.1186/s12913-018-3092-zLeaving the emergency department without complete care: disparities in American Indian childrenTess L. Weber0Katherine M. Ziegler1Anupam B. Kharbanda2Nathaniel R. Payne3Chad Birger4Susan E. Puumala5Sanford ResearchColorado School of Public Health at the University of Colorado at DenverChildren’s Hospitals and Clinics of MinnesotaChildren’s Hospitals and Clinics of MinnesotaSanford ResearchSanford ResearchAbstract Background Children who leave the emergency department (ED) without complete evaluation or care (LWCET) have poorer outcomes in general. Previous studies have found that American Indian (AI) children have higher rates of LWCET than other racial or ethnic groups. Therefore, this study aims to examine LWCET in AI children by exploring differences by ED location and utilization patterns. Methods This is a retrospective cohort study of five EDs in the upper Midwest between June 2011 and May 2012. We included all visits by children aged 0–17 who identified as African American (AA), AI or White. Logistic regression was used to determine differences in LWCET by race and ED location controlling for other possible confounding factors including sex, age, insurance type, triage level, distance from ED, timing of visit, and ED activity level. Results LWCET occurred in 1.73% of 68,461 visits made by 47,228 children. The multivariate model revealed that AIs were more likely to LWCET compared to White children (Odds Ratio (OR) = 1.62, 95% Confidence Interval (CI) = 1.30–2.03). There was no significant difference in LWCET between AA and White children. Other factors significantly associated with LWCET included triage level, distance from the ED, timing of visit, and ED activity level. Conclusion Our results show that AI children have higher rates of LWCET compared to White children; this association is different from other racial minority groups. There are likely complex factors affecting LWCET in AI children throughout the upper Midwest, which necessitates further exploration.http://link.springer.com/article/10.1186/s12913-018-3092-zPediatricEmergency departmentAmerican IndianDisparities |
| spellingShingle | Tess L. Weber Katherine M. Ziegler Anupam B. Kharbanda Nathaniel R. Payne Chad Birger Susan E. Puumala Leaving the emergency department without complete care: disparities in American Indian children BMC Health Services Research Pediatric Emergency department American Indian Disparities |
| title | Leaving the emergency department without complete care: disparities in American Indian children |
| title_full | Leaving the emergency department without complete care: disparities in American Indian children |
| title_fullStr | Leaving the emergency department without complete care: disparities in American Indian children |
| title_full_unstemmed | Leaving the emergency department without complete care: disparities in American Indian children |
| title_short | Leaving the emergency department without complete care: disparities in American Indian children |
| title_sort | leaving the emergency department without complete care disparities in american indian children |
| topic | Pediatric Emergency department American Indian Disparities |
| url | http://link.springer.com/article/10.1186/s12913-018-3092-z |
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