Disparities in Clinical Ethics Consultation among Hospitalized Children: A Case-Control Study.
J Pediatr
; 258: 113415, 2023 07.
Article
em En
| MEDLINE
| ID: mdl-37028752
ABSTRACT
OBJECTIVE:
To identify sociodemographic factors associated with pediatric clinical ethics consultation (CEC). STUDYDESIGN:
Matched, case-control study at a single center, tertiary pediatric hospital in the Pacific Northwest. Cases (patients hospitalized January 2008-December 2019 with CEC) were compared with controls (those without CEC). We determined the association of the outcome (CEC receipt) with exposures (race/ethnicity, insurance status, and language for care) using univariate and multivariable conditional logistic regression.RESULTS:
Of 209 cases and 836 matched controls, most cases identified as white (42%), had public/no insurance (66%), and were English-speaking (81%); most controls identified as white (53%), had private insurance (54%), and were English-speaking (90%). In univariate analysis, patients identifying as Black (OR 2.79, 95% CI 1.57, 4.95; P < .001), Hispanic (OR 1.92, 95% CI 1.24, 2.97; P = .003), with public/no insurance (OR 2.21, 95% CI 1.58, 3.10; P < .001), and using Spanish language for care (OR 2.52, 95% CI 1.47, 4.32; P < .001) had significantly increased odds of CEC, compared with patients identifying as white, using private insurance, and using English for care, respectively. In multivariable regression, Black race (adjusted OR 2.12, 95% CI 1.16, 3.87; P = .014) and public/no insurance (adjusted OR 1.81, 95% CI 1.22, 2.68; P = .003) remained significantly associated with receipt of CEC.CONCLUSIONS:
We found disparities in receipt of CEC by race and insurance status. Further study is needed to determine the causes of these disparities.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Criança Hospitalizada
/
Consultoria Ética
/
Disparidades em Assistência à Saúde
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
Idioma:
En
Revista:
J Pediatr
Ano de publicação:
2023
Tipo de documento:
Article