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A review of racial/ethnic disparities in pediatric trauma care, treatment, and outcomes

LaPlant, Melanie B., MPH; Hess, Donavon J., MD, PhD

Journal of Trauma and Acute Care Surgery: March 2019 - Volume 86 - Issue 3 - p 540–550
doi: 10.1097/TA.0000000000002160
REVIEW ARTICLE
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ABSTRACT Health disparities are an increasingly researched topic in the United States. Evidence of disparities found across the spectrum of health care includes pediatric patients. The purpose of this review is to comprehensively summarize disparities among pediatric trauma patients, evaluating both emergency department and hospital treatment and outcomes. Multiple studies describe disparities in a variety of areas of trauma care including emergency department, radiology, surgery, abuse evaluation, and discharge rehabilitation. More concerning, multiple studies report disparities in length of stay, disability, recidivism, and mortality. This review also highlights several gaps in disparity research including specialty care, inclusion of all racial/ethnic groups, and geographic differences. Few of the reviewed studies described disparity interventions; however, research regarding abuse evaluations showed that care guidelines diminished disparity. Trauma care, a routinized patient service, is subject to existing care guidelines and quality improvement programs, and may be the ideal health care setting for disparity intervention.

LEVEL OF EVIDENCE Study type review, level V.

From the Division of Pediatric Surgery, Department of Surgery (M.B.L., D.J.H.), University of Minnesota, Minneapolis, Minnesota.

Submitted: July 12, 2018, Revised: October 16, 2018, Accepted: November 25, 2018, Published online: December 7, 2018.

Address for reprints: Donavon J. Hess, MD, PhD, Department of Surgery, University of Minnesota, 2450 Riverside Ave S. MB 505, Minneapolis, MN; email: lapla055@umn.edu, hessx006@umn.edu.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.jtrauma.com).

© 2019 Lippincott Williams & Wilkins, Inc.