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Disparities in Pediatric Specialty Referral Scheduling and Completion.
Srinivasan, Anisha P; Sullivan, Erin; Desai, Arti; Adiele, Alicia; Bell, Shaquita; Lion, K Casey.
Afiliação
  • Srinivasan AP; Department of Pediatrics, MIND Institute, University of California, Davis, Sacramento, CA. Electronic address: apsrinivasan@ucdavis.edu.
  • Sullivan E; Seattle Children's Hospital and Research Institute, Seattle, WA.
  • Desai A; Seattle Children's Hospital and Research Institute, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA.
  • Adiele A; Seattle Children's Hospital and Research Institute, Seattle, WA.
  • Bell S; Seattle Children's Hospital and Research Institute, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA.
  • Lion KC; Seattle Children's Hospital and Research Institute, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA.
J Pediatr ; 260: 113485, 2023 09.
Article em En | MEDLINE | ID: mdl-37196777
OBJECTIVE: To estimate differences in scheduled and completed specialty referrals by race, ethnicity, language for care, and insurance type. STUDY DESIGN: We studied a retrospective cohort of 38 334 specialty referrals to a large children's hospital between March 2019 and March 2021. We included referrals for patients with primary care clinics within 5 miles of the hospital. We examined whether the odds of and time to scheduled and completed referrals differed by patient sociodemographic characteristics. RESULTS: Of all referrals, 62% were scheduled and 54% were completed. Referral completion rates were lower for patients with Black race (45%), Native Hawaiian/Pacific Islander race (48%), Spanish language (49%), and public insurance (47%). Odds of scheduled and completed referral were lower for Asian (aOR scheduled: 0.94, [95% CI: 0.89, 0.99]; aOR completed: 0.92 [0.87, 0.97]), Black (aOR scheduled: 0.86 [0.79, 0.94]; aOR completed: 0.80 [0.73, 0.87]), and publicly insured patients (aOR scheduled: 0.71 [0.66, 0.75]; aOR completed: 0.70 [0.66, 0.75]). Time to scheduled and completed referral was longer for Black (adjusted hazard ratio [aHR] scheduled: 0.93 [0.88, 0.98]; aHR completed: 0.93 [0.87, 0.99]) and publicly insured patients (aHR scheduled: 0.85 [0.82, 0.88]; aHR completed: 0.84 [0.80, 0.87]) and families with a language other than English (aHR scheduled: 0.66 [0.62, 0.70]; aHR completed: 0.92 [0.86, 0.99]). CONCLUSIONS: Within a geographically homogenous pediatric population, the odds and time to scheduled and completed specialty referrals differed by sociodemographic characteristics, suggesting the effects of discrimination. To improve access equity, health care organizations need clear and consistent referral workflows and more comprehensive metrics for access.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pediatria / Encaminhamento e Consulta / Disparidades em Assistência à Saúde Tipo de estudo: Observational_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Child / Humans Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pediatria / Encaminhamento e Consulta / Disparidades em Assistência à Saúde Tipo de estudo: Observational_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Child / Humans Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos