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Children's Health

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Patterns of care and outcomes of pneumonia in children vary substantially by ethnicity and race

The patterns of pneumonia care and outcomes of care vary substantially among children of different ethnic/racial groups, according to a recent study that was supported by the Agency for Healthcare Research and Quality (HS13056). For example, minority children were hospitalized for pneumonia at younger ages than white children, were more likely to be admitted to the hospital through the emergency department (ED), and were less likely to receive bronchoscopy or mechanical ventilation. Hispanic and Asian infants younger than 3 months were more likely than white or black infants to be hospitalized for pneumonia. Among children 3 months to 4 years of age with pneumonia, Hispanics had the highest percentage of children admitted to the hospital, followed by Asians, blacks, and whites.

More black children were admitted to the hospital through the ED (67 percent) followed by Hispanic, Asian, and white children (59, 49, and 42 percent, respectively). More Hispanic and Asian children suffered from respiratory failure as identified by the need for mechanical ventilation (both at 3 percent) than black and white children (both at 2 percent). However, minority children were less likely than white children to receive either bronchoscopy or mechanical ventilation. Hispanic children had the longest average hospital stay (5.1 days), followed by Asian children (3.9 days), blacks (3.6 days), and whites (3.5 days). The total charges from highest to lowest were for Hispanic children (median $6,770), Asian children (median $6,154), black children (median $4,690), and white children (median $3,988). In conclusion, the researchers note the need for additional studies to better clarify how differences in quality of care, access to care, disease severity, and care-seeking behaviors contribute to ethnic differences in care outcomes.

For the study, researchers from Governors State University, University Park, IL, used abstracted data on pediatric hospital stays from the 1998, 1999, and 2000 Nationwide Inpatient Sample (NIS). The NIS, which contains data on 20 percent of total U.S. hospital discharges, is maintained by AHRQ and is a component of the Healthcare Cost and Utilization Project.

See "Patterns of hospital-based pediatric care across diverse ethnicities: The case of pneumonia," by Elmer I. Washington, M.D., M.P.H., Jay J. Shen, Ph.D., Ralph Bell, Ph.D., and others, in the Journal of Health Care for the Poor and Underserved 15, pp. 462-473, 2004.

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