Kate Balestracci, Linda Sebelia, Geoffrey Greene, Adam Moore, Grayson Baird, Kelsi Chappell, Alison Tovar
Effect of a Technology-Integrated Curriculum on Sugary Drink and Snack Intake of Elementary-Aged Youth Experiencing Low Income
Journal of nutrition education and behavior
disparities outcomes adult sepsis well described insurance status race ethnicity paucity data looking disparities sepsis outcomes children aimed determine whether hospital outcomes childhood severe sepsis influenced race ethnicity insurance status proxy socioeconomic position populationbased retrospective cohort study used data 2016 database release healthcare cost utilization project kids inpatient database kid 2016 kid included 3 117 413 discharges accounting 80 national paediatric discharges 4200 us hospitals across 47 states using multilevel logistic regression clustered hospital tested association race ethnicity insurance status hospital mortality adjusting individuallevel hospitallevel characteristics children severe sepsis secondary outcome length hospital stay examined multilevel time event hospital discharge regression death competing risk 12 297 children aged 021 years severe sepsis without shock admitted 1253 hospitals 2016 kid dataset 1265 103 12 297 patients race ethnicity data recorded 15 01 missing data insurance 1324 108 transferred hospital resulting final cohort 9816 children black children higher odds death white children adjusted odds ratio 119 95 ci 102138 p0028 driven higher black mortality south 130 104162 p0019 west 158 105238 p0027 usa found evidence longer hospital stays hispanic children adjusted hazard ratio 094 95 ci 088100 p0049 black children 088 082094 p00002 particularly black neonates 053 95 ci 036077 p00011 observed difference survival publicly privately insured children however insurance status selfpay charge associated increased mortality adjusted 130 95 ci 104161 p0021 large representative analysis paediatric severe sepsis usa found evidence outcome disparities race ethnicity insurance status findings suggest might differential sepsis recognition approaches treatment access healthcare services provider bias contribute poorer sepsis outcomes racial ethnic minority patients lower socioeconomic position studies warranted investigate mechanisms poorer sepsis outcomes black hispanic children none