Racial and ethnic differences in pediatric surgery utilization in the United States: A nationally representative cross-sectional analysis
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In brief
In brief
This nationally representative study reveals significant racial and ethnic disparities in pediatric surgical utilization, with minority children having substantially lower odds of receiving ambulatory surgery compared to non-Hispanic White children, even after controlling for insurance, income, and health status. The findings suggest systemic barriers to surgical care access for minority pediatric populations in the United States.
Written by the GCMD Library team from the article.
Objectives
Children of minority background have reduced access to surgery. This study assessed for racial/ethnic differences in surgical utilization by location.
Materials and Methods
We conducted a cross-sectional analysis of U.S. children (0-17 years of age) participating in the nationally representative Medical Expenditure Panel Survey (MEPS, 2015-2018). Race/ethnicity was the variable of interest. The primary outcome variables were prevalence rates of surgery defined by location of surgical procedure (inpatient, emergency department, hospital outpatient, and office). Covariates included contextual factors that may influence access to and need for healthcare services, including age, sex, insurance status, residential geographic status, usual source of care, and parental reports of child's physical and mental health. We employed multivariate logistic regression models to assess the relationship between outcomes and race/ethnicity.
Results
The study population included 31,024 children with an overall surgical rate of 4.8%. Adjusted odds of surgery in an ambulatory location were lower for all racial/ethnic minority groups compared to non-Hispanic White counterparts (non-Hispanic Black aOR=0.3, 95% CI: 0.2-0.5; Hispanic aOR=0.4, 95% CI: 0.3-0.6; non-Hispanic Asian aOR=0.2, 95% CI 0.0-0.5 for hospital outpatient surgery; for office-based setting, non-Hispanic Black aOR=0.4, 95% CI 0.3-0.6; Hispanic aOR=0.5, 95% CI: 0.4-0.7; non-Hispanic Asian aOR=0.4; 95% CI 0.3-0.7). No racial/ethnic differences were observed for surgical procedures in inpatient or emergency department locations.
Conclusions
Staggering differences exist in pediatric surgery utilization patterns by racial/ethnic background, even after adjusting for important contextual factors (income, insurance, health status). Our findings in a nationally representative dataset may suggest systemic barriers related to racial/ethnic background for the pediatric surgical population.