Healthcare Disparities in Early Childhood Brain Injury

Abstract

<h3>Research Objectives</h3> While healthcare and educational disparities are known to impact minoritized groups, few research studies have been conducted to examine disparities after childhood acquired brain injury (ABI). The purpose of this study was to explore child factors associated with referral (i.e., race, socioeconomic status, type and time since injury, length of hospital stay), parent education, and long-term need for children who experienced an early childhood ABI. <h3>Design</h3> Secondary-analysis of data collected through retrospective cohort chart review and prospective caregiver phone surveys. <h3>Setting</h3> Large, urban Trauma 1 pediatric hospital in the Midwestern US. <h3>Participants</h3> 29 caregivers of children who experienced an ABI before five years of age and currently in elementary or middle school. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Medical records and a 10-min phone survey that included a series of yes/no and short open-ended questions. <h3>Results</h3> Logistic regressions indicated a significant association between child factors and 1) referral to services at hospital discharge (p = .004) and 2) caregiver-reported long-term need for special education services (met and unmet; p = .009). The models for caregiver-reported receipt of education on ABI and caregiver-reported unmet need for special education were not significant. For both significant models, there were no significant individual predictors, but some factors appear to have stronger associations than others. <h3>Conclusions</h3> Differences in acute and long-term service provision and need after childhood ABI are likely influenced by a complex interaction of individual, injury, and social-environmental factors. Future research should consider how healthcare and education practice and policy might account for these interactions to support more equitable access to and utilization of services to improve long-term outcomes for all children with ABI. <h3>Author(s) Disclosures</h3> Jessica Salley Riccardi and Jennifer Lundine have no financial or non-financial relationships to disclose.