Abstract
Objectives: To determine if there are racial/ethnic differences in the rates of appendiceal rupture among the children of two large states. Because rupture is primarily due to delayed diagnosis, differences would suggest disparities in timely access to quality emergency care. Methods: This was an observational, cross-sectional analysis of full-year samples of acute appendicitis cases from California and New York children 4 to 18 years old. Racial/ethnic groups were compared for risk of appendiceal rupture adjusted for biological factors both before and after adjustment for the following socioeconomic, hospital, and admission characteristics: income, insurance, hospital type, and admission source. Results were interpreted in light of census data on the proportion of immigrants in each racial/ethnic group. Results: Compared with white children with acute appendicitis, Hispanic and Asian children have higher odds of rupture in California, whereas Asian and black/African American children have higher odds in New York. These differences roughly parallel the within-state proportion of immigrant children in these groups. Adjustments for family, socioeconomic, and hospital characteristics attenuate but do not eliminate disparities. Conclusions: The authors found evidence of significant racial/ethnic disparities in rate of appendiceal rupture, an important and preventable outcome, in two large but dissimilar states. Immigrant groups may be most at risk for delayed emergency care. Future research should focus on immigration and acculturation as risk factors for appendicitis rupture in children.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1218-1227 |
| Number of pages | 10 |
| Journal | Academic Emergency Medicine |
| Volume | 10 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2003 |
| Externally published | Yes |
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Keywords
- Appendicitis
- Children
- Disparity
- Emergencies
- Race
ASJC Scopus subject areas
- Emergency Medicine
Cite this
Racial and Ethnic Disparities in Pediatric Appendicitis Rupture Rate. / Guagliardo, Mark F.; Teach, Stephen J.; Huang, Zhihuan J.; Chamberlain, James M.; Joseph, Jill G.
In: Academic Emergency Medicine, Vol. 10, No. 11, 11.2003, p. 1218-1227.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Racial and Ethnic Disparities in Pediatric Appendicitis Rupture Rate
AU - Guagliardo, Mark F.
AU - Teach, Stephen J.
AU - Huang, Zhihuan J.
AU - Chamberlain, James M.
AU - Joseph, Jill G
PY - 2003/11
Y1 - 2003/11
N2 - Objectives: To determine if there are racial/ethnic differences in the rates of appendiceal rupture among the children of two large states. Because rupture is primarily due to delayed diagnosis, differences would suggest disparities in timely access to quality emergency care. Methods: This was an observational, cross-sectional analysis of full-year samples of acute appendicitis cases from California and New York children 4 to 18 years old. Racial/ethnic groups were compared for risk of appendiceal rupture adjusted for biological factors both before and after adjustment for the following socioeconomic, hospital, and admission characteristics: income, insurance, hospital type, and admission source. Results were interpreted in light of census data on the proportion of immigrants in each racial/ethnic group. Results: Compared with white children with acute appendicitis, Hispanic and Asian children have higher odds of rupture in California, whereas Asian and black/African American children have higher odds in New York. These differences roughly parallel the within-state proportion of immigrant children in these groups. Adjustments for family, socioeconomic, and hospital characteristics attenuate but do not eliminate disparities. Conclusions: The authors found evidence of significant racial/ethnic disparities in rate of appendiceal rupture, an important and preventable outcome, in two large but dissimilar states. Immigrant groups may be most at risk for delayed emergency care. Future research should focus on immigration and acculturation as risk factors for appendicitis rupture in children.
AB - Objectives: To determine if there are racial/ethnic differences in the rates of appendiceal rupture among the children of two large states. Because rupture is primarily due to delayed diagnosis, differences would suggest disparities in timely access to quality emergency care. Methods: This was an observational, cross-sectional analysis of full-year samples of acute appendicitis cases from California and New York children 4 to 18 years old. Racial/ethnic groups were compared for risk of appendiceal rupture adjusted for biological factors both before and after adjustment for the following socioeconomic, hospital, and admission characteristics: income, insurance, hospital type, and admission source. Results were interpreted in light of census data on the proportion of immigrants in each racial/ethnic group. Results: Compared with white children with acute appendicitis, Hispanic and Asian children have higher odds of rupture in California, whereas Asian and black/African American children have higher odds in New York. These differences roughly parallel the within-state proportion of immigrant children in these groups. Adjustments for family, socioeconomic, and hospital characteristics attenuate but do not eliminate disparities. Conclusions: The authors found evidence of significant racial/ethnic disparities in rate of appendiceal rupture, an important and preventable outcome, in two large but dissimilar states. Immigrant groups may be most at risk for delayed emergency care. Future research should focus on immigration and acculturation as risk factors for appendicitis rupture in children.
KW - Appendicitis
KW - Children
KW - Disparity
KW - Emergencies
KW - Race
UR - http://www.scopus.com/inward/record.url?scp=0242581664&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0242581664&partnerID=8YFLogxK
U2 - 10.1197/S1069-6563(03)00492-5
DO - 10.1197/S1069-6563(03)00492-5
M3 - Article
C2 - 14597498
AN - SCOPUS:0242581664
VL - 10
SP - 1218
EP - 1227
JO - Academic Emergency Medicine
JF - Academic Emergency Medicine
SN - 1069-6563
IS - 11
ER -