Racial Inequity in High-Risk Infant Follow-Up Among Extremely Low Birth Weight Infants

被引:11
|
作者
Fraiman, Yarden S. [1 ,2 ,3 ,9 ]
Edwards, Erika M. [4 ,5 ,6 ,7 ]
Horbar, Jeffrey D. [4 ,5 ,6 ]
Mercier, Charles E. [5 ,6 ]
Soll, Roger F. [4 ,5 ,6 ]
Litt, Jonathan S. [1 ,2 ,3 ,8 ]
机构
[1] Beth Israel Deaconess Med Ctr, Dept Neonatol, Boston, MA USA
[2] Boston Childrens Hosp, Dept Pediat, Div Newborn Med, Boston, MA USA
[3] Harvard Med Sch, Dept Pediat, Boston, MA USA
[4] Vermont Oxford Network, Burlington, VT USA
[5] Univ Vermont, Coll Med, Dept Pediat, Vermont, MD USA
[6] Univ Vermont, Childrens Hosp, Burlington, VT USA
[7] Univ Vermont, Coll Engn & Math Studies, Dept Math & Stat, Burlington, VT USA
[8] Harvard TH Chan Sch Publ Hlth, Boston, MA USA
[9] Beth Israel Deaconess Med Ctr, Dept Neonatol, 330 Brookline Ave,Rose 3, Boston, MA 02215 USA
关键词
EARLY INTERVENTION; PRETERM BIRTH; CARE; HEALTH; DISPARITIES; FRAMEWORK; MORTALITY; AGE;
D O I
10.1542/peds.2022-057865
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BACKGROUND AND OBJECTIVES High-risk infant follow-up programs (HRIFs) are a recommended standard of care for all extremely low birth weight (ELBW) infants to help mitigate known risks to long-term health and development. However, participation is variable, with known racial and ethnic inequities, though hospital-level drivers of inequity remain unknown. We conducted a study using a large, multicenter cohort of ELBW infants to explore within- and between-hospital inequities in HRIF participation.METHODS Vermont Oxford Network collected data on 19 503 ELBW infants born between 2006 and 2017 at 58 US hospitals participating in the ELBW Follow-up Project. Primary outcome was evaluation in HRIF at 18 to 24 months' corrected age. The primary predictor was infant race and ethnicity, defined as maternal race (non-Hispanic white, non-Hispanic Black, Hispanic, Asian American, Native American, other). We used generalized linear mixed models to test within- and between-hospital variation and inequities in HRIF participation.RESULTS Among the 19 503 infants, 44.7% (interquartile range 31.1-63.3) were seen in HRIF. Twenty six percent of the total variation in HRIF participation rates was due to between-hospital variation. In adjusted models, Black infants had significantly lower odds of HRIF participation compared with white infants (adjusted odds ratio, 0.73; 95% confidence interval, 0.64-0.83). The within-hospital effect of race varied significantly between hospitals.CONCLUSIONS There are significant racial inequities in HRIF participation, with notable variation within and between hospitals. Further study is needed to identify potential hospital-level targets for interventions to reduce this inequity.
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页数:10
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