Abstract 12969: Impact of Race and Ethnicity on Hospital Morbidity and Resource Utilization in Acute Care Pediatric Cardiology Patients

Abstract

Introduction: Disparities in healthcare outcomes are well described among patients of different races and ethnicities including pediatric cardiology. Multicenter studies examining these outcomes are lacking in pediatric acute care cardiology. We hypothesize that Black and Hispanic patients admitted to pediatric acute care cardiology units have increased hospital and acute care encounter length of stay (LOS) and complication rates compared to their White and non-Hispanic peers. Methods: Utilizing the Pediatric Acute Care Cardiology Collaborative registry, we examined all acute care cardiology unit encounters from 2/1/2019 to 7/30/2021 ending in discharge to home or death. Hospitalizations were categorized by race and ethnicity. In-hospital complications included health-care acquired infections, iatrogenic incidents, pneumonia, sepsis, seizures and stroke. Data were analyzed for differences in LOS and complication rates using chi-square and ANOVA testing. We used Bonferroni correction to establish a significance threshold of 0.007. Results: Analysis included 30,404 hospitalizations from 29 centers. There were 16,233 White (70%), 4,533 Black (19%), 919 Asian (4%) and 1,629 other races (7%) encounters. There were 23,592 (78%) non-Hispanic and 4,583 (15%) Hispanic encounters. Black patients had higher rates of premature birth (21.4%) and low birth weight (10.7%), compared to White patients (15.6% and 5.9% respectively, p<0.0001). Both non-Hispanic Black and Hispanic patients had longer total hospital and acute care LOS than non-Hispanic White patients. Complication rates analyzed by race trended towards significance between Black and White patients, and Hispanic patients had a higher complication rate than non-Hispanics. ( Table 1 ) Conclusions: Despite improved outcomes for patients with congenital and acquired heart disease, significant racial and ethnic disparities continue to exist. Directed efforts are needed to achieve equitable results.