Length of stay is one way to measure how severely an illness affects a population. This study analyzes length of stay disparities in several pediatric illnesses, including asthma.
Inequities in the quality of care for pediatric illnesses have historically impacted marginalized races and ethnicities in a negative way. Among the many metrics that can be used to evaluate the severity of illness and disparities in care is length of stay, as it is associated with higher costs and complications.
Previous studies have demonstrated length of stay disparities among Black and Hispanic children for specific disease diagnoses, but have not been able to provide a clear understanding of how these disparities change over time, as well as which conditions they affect disproportionally. This article, published in the journal Hospital Pediatrics, examines the way that length of stay disparities affect the most common pediatric conditions, including asthma, which is one of the most common health conditions that children face.
Analyzing the Most Frequent Diagnoses For Pediatric Patients
The data for this study were gathered from the 2016 and 2019 Kids’ Inpatient Databases, and analyses were run on the 10 most frequent diagnoses, including appendicitis, asthma, and diabetes. A linear mixed effects model with a negative binomial distribution was used to analyze the relationship between race and length of stay for each of these disease categories. Associations over 2 years were then analyzed to better understand changes over time.
Racial Disparities in Length of Stay Discovered for Many Pediatric Diagnoses
Statistically significant relationships between race/ethnicity and length of stay were found for 8 out of the top 10 diagnoses for 2016, including asthma. However, in 2019 asthma was not included among the 7 out of 10 diagnoses for which there were significant relationships between these two metrics. For Hispanic children, the disparities in length of stay decreased for several conditions, and were no longer seen at all for asthma.
Asthma is one of many conditions that negatively impact patients from certain racial and ethnic groups. Different conditions were found to affect different racial groups in varying ways, and this article suggests that the cause of health inequities such as length of stay are most likely multifactorial, and lead to a number of effects. The impacts of disparate outcomes for pediatric patients is considerable and can have compounding effects on their lives, as they miss school and can experience trauma and stress.
Harrington, Y., Rauch, D. A., & Leary, J. C. (2023). Racial and Ethnic Disparities in Length of Stay for Common Pediatric Diagnoses: Trends From 2016 to 2019. Hospital Pediatrics, 13(4), 275–282. https://doi.org/10.1542/hpeds.2021-006471