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. 2023 Jul 3;10(Suppl 1):31.
doi: 10.1186/s40621-023-00441-w.

Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department

Laura Even Elliott  1 , Michael A Gittelman  2 , Eileen M Kurowski  3 , Elena M Duma  4 , Wendy J Pomerantz  2
Affiliations

Impact of standardization on racial and socioeconomic disparities in non-accidental trauma evaluations in infants in a pediatric emergency department

Laura Even Elliott et al. Inj Epidemiol..

Abstract

Background: Studies have illustrated racial and socioeconomic disparities in evaluation of non-accidental trauma (NAT). We aimed to investigate how implementation of a standardized NAT guideline in a pediatric emergency department (PED) impacted racial and socioeconomic disparities in NAT evaluation.

Results: 1199 patients (541 pre- and 658 post-guideline) were included for analysis. Pre-guideline, patients with governmental insurance were more likely than those with commercial insurance to have a social work (SW) consult completed (57.4% vs. 34.7%, p < 0.001) and a Child Protective Services (CPS) report filed (33.4% vs. 13.8%, p < 0.001). Post-guideline, these disparities were still present. There were no differences in race, ethnicity, insurance type, or social deprivation index (SDI) in rates of complete NAT evaluations pre- or post-guideline implementation. Overall adherence to all guideline elements increased from 19.0% before guideline implementation to 53.2% after (p < 0.001).

Conclusion: Implementation of a standardized NAT guideline led to significant increase in complete NAT evaluations. Guideline implementation was not associated with elimination of pre-existing disparities in SW consults or CPS reporting between insurance groups.

Keywords: Disparities; Infant; Non-accidental trauma; Standardization.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram. *LWBS/AMA = Left without being seen/against medical advice
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References

    1. Brokamp C, LeMasters GK, Ryan PH. Residential mobility impacts exposure assessment and community socioeconomic characteristics in longitudinal epidemiology studies. J Expo Sci Environ Epidemiol. 2016;26(4):428–34. doi: 10.1038/jes.2016.10. - DOI - PMC - PubMed
    1. Degraw M, et al. Incidence of fractures among children with burns with concern regarding abuse. Pediatrics. 2010;125(2):e295–9. doi: 10.1542/peds.2009-1478. - DOI - PubMed
    1. DeRidder CA, et al. Subconjunctival hemorrhages in infants and children: a sign of nonaccidental trauma. Pediatr Emerg Care. 2013;29(2):222–6. doi: 10.1097/PEC.0b013e318280d663. - DOI - PubMed
    1. Harper NS, et al. Additional injuries in young infants with concern for abuse and apparently isolated bruises. J Pediatr. 2014;165(2):383–388e1. doi: 10.1016/j.jpeds.2014.04.004. - DOI - PubMed
    1. Higginbotham N, et al. Utility of a child abuse screening guideline in an urban pediatric emergency department. J Trauma Acute Care Surg. 2014;76(3):871–7. doi: 10.1097/TA.0000000000000135. - DOI - PubMed

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