SHM Converge Scientific Abstract ePoster Gallery-Racial/Ethnic Disparities in Transfers to Children's Hospitals in 2019

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This study examined whether racial and ethnic disparities exist in pediatric hospital transfers and whether they differ by hospital type. Using 2019 Kids’ Inpatient Database data, the authors analyzed transfer admissions by race/ethnicity across urban non-teaching hospitals, urban teaching hospitals, and freestanding children’s hospitals. They adjusted for age, sex, hospital region, number of diagnoses, zip-code income quartile, illness risk, and primary payer.<br /><br />The analysis found that hospital type significantly modified the relationship between race/ethnicity and the likelihood of transfer in, so results were stratified by hospital type. Compared with White children, Black and Hispanic children had lower odds of being transferred into all hospital types studied. The most notable reductions were seen in urban teaching hospitals, where odds ratios were 0.654 for Black children and 0.641 for Hispanic children. Lower odds were also observed in urban non-teaching hospitals (0.845 and 0.848) and freestanding children’s hospitals (0.794 and 0.760). These findings were statistically significant in nearly all cases, except for Asian/Pacific Islander/Native American/Other children at urban non-teaching hospitals.<br /><br />Overall, the study concludes that children from historically marginalized racial and ethnic groups were less likely to be transferred from another facility than White children in 2019. The authors suggest that social determinants of health may create barriers to transfer, or that implicit bias among clinicians could contribute. Further research is needed to identify the underlying causes of these disparities and how to address them.

Asset Subtitle

Daniel Rauch

Meta Tag

Author List Bruna S. Voldman, Daniel Rauch, Jana C. Leary, Yevgeniya Harrington

Category Research

Concept Race and Ethnicity

Concept Pediatric Inter-Hospital Transfer

Concept Hospital Type

Concept Historically Marginalized Racial/Ethnic Groups

Concept Kids Inpatient Database

Distinguished Non-Finalist

Presenter Organization Hackensack Meridian School of Medicine

Presenting Author Daniel Rauch

Track Pediatric

Keywords

pediatric hospital transfers

racial disparities

ethnic disparities

hospital type

transfer admissions

Black children

Hispanic children

urban teaching hospitals

freestanding children’s hospitals

social determinants of health

Race and Ethnicity

Pediatric Inter-Hospital Transfer

Hospital Type

Historically Marginalized Racial/Ethnic Groups

Kids Inpatient Database