Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department
Abstract Background Studies have illustrated racial and socioeconomic disparities in evaluation of non-accidental trauma (NAT). We aimed to investigate how implementation of a standardized NAT guideline in a pediatric emergency department (PED) impacted racial and socioeconomic disparities in NAT ev...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Injury Epidemiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40621-023-00441-w |
| _version_ | 1827328884777943040 |
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| author | Laura Even Elliott Michael A. Gittelman Eileen M. Kurowski Elena M. Duma Wendy J. Pomerantz |
| author_facet | Laura Even Elliott Michael A. Gittelman Eileen M. Kurowski Elena M. Duma Wendy J. Pomerantz |
| author_sort | Laura Even Elliott |
| collection | DOAJ |
| description | Abstract Background Studies have illustrated racial and socioeconomic disparities in evaluation of non-accidental trauma (NAT). We aimed to investigate how implementation of a standardized NAT guideline in a pediatric emergency department (PED) impacted racial and socioeconomic disparities in NAT evaluation. Results 1199 patients (541 pre- and 658 post-guideline) were included for analysis. Pre-guideline, patients with governmental insurance were more likely than those with commercial insurance to have a social work (SW) consult completed (57.4% vs. 34.7%, p < 0.001) and a Child Protective Services (CPS) report filed (33.4% vs. 13.8%, p < 0.001). Post-guideline, these disparities were still present. There were no differences in race, ethnicity, insurance type, or social deprivation index (SDI) in rates of complete NAT evaluations pre- or post-guideline implementation. Overall adherence to all guideline elements increased from 19.0% before guideline implementation to 53.2% after (p < 0.001). Conclusion Implementation of a standardized NAT guideline led to significant increase in complete NAT evaluations. Guideline implementation was not associated with elimination of pre-existing disparities in SW consults or CPS reporting between insurance groups. |
| first_indexed | 2024-03-07T15:24:49Z |
| format | Article |
| id | doaj.art-72a66f39977847928e183900bec5c03a |
| institution | Directory Open Access Journal |
| issn | 2197-1714 |
| language | English |
| last_indexed | 2024-03-07T15:24:49Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Injury Epidemiology |
| spelling | doaj.art-72a66f39977847928e183900bec5c03a2024-03-05T17:23:44ZengBMCInjury Epidemiology2197-17142023-07-0110S11710.1186/s40621-023-00441-wImpact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency departmentLaura Even Elliott0Michael A. Gittelman1Eileen M. Kurowski2Elena M. Duma3Wendy J. Pomerantz4Division of Emergency Medicine, Cincinnati Children’s HospitalDivision of Emergency Medicine, Comprehensive Children’s Injury Center, Cincinnati Children’s HospitalDivision of Emergency Medicine, James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s HospitalDivision of Emergency Medicine, Cincinnati Children’s HospitalDivision of Emergency Medicine, Comprehensive Children’s Injury Center, Cincinnati Children’s HospitalAbstract Background Studies have illustrated racial and socioeconomic disparities in evaluation of non-accidental trauma (NAT). We aimed to investigate how implementation of a standardized NAT guideline in a pediatric emergency department (PED) impacted racial and socioeconomic disparities in NAT evaluation. Results 1199 patients (541 pre- and 658 post-guideline) were included for analysis. Pre-guideline, patients with governmental insurance were more likely than those with commercial insurance to have a social work (SW) consult completed (57.4% vs. 34.7%, p < 0.001) and a Child Protective Services (CPS) report filed (33.4% vs. 13.8%, p < 0.001). Post-guideline, these disparities were still present. There were no differences in race, ethnicity, insurance type, or social deprivation index (SDI) in rates of complete NAT evaluations pre- or post-guideline implementation. Overall adherence to all guideline elements increased from 19.0% before guideline implementation to 53.2% after (p < 0.001). Conclusion Implementation of a standardized NAT guideline led to significant increase in complete NAT evaluations. Guideline implementation was not associated with elimination of pre-existing disparities in SW consults or CPS reporting between insurance groups.https://doi.org/10.1186/s40621-023-00441-wNon-accidental traumaInfantStandardizationDisparities |
| spellingShingle | Laura Even Elliott Michael A. Gittelman Eileen M. Kurowski Elena M. Duma Wendy J. Pomerantz Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department Injury Epidemiology Non-accidental trauma Infant Standardization Disparities |
| title | Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department |
| title_full | Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department |
| title_fullStr | Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department |
| title_full_unstemmed | Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department |
| title_short | Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department |
| title_sort | impact of standardization on racial and socioeconomic disparities in non accidental trauma evaluations in infants in a pediatric emergency department |
| topic | Non-accidental trauma Infant Standardization Disparities |
| url | https://doi.org/10.1186/s40621-023-00441-w |
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