Disparities in Clinical Ethics Consultation among Hospitalized Children: A Case-Control Study - 05/07/23
, Chuan Zhou, PhD 2, 3, Jiana Ugale, BS 4, ∗, Jessica Ramos, BS 5, Arika Patneaude, MSW, LICSW, APHSW-C 4, 6, 7, Douglas J. Opel, MD, MPH 2, 4, 6Abstract |
Objective |
To identify sociodemographic factors associated with pediatric clinical ethics consultation (CEC).
Study design |
Matched, case-control study at a single center, tertiary pediatric hospital in the Pacific Northwest. Cases (patients hospitalized January 2008-December 2019 with CEC) were compared with controls (those without CEC). We determined the association of the outcome (CEC receipt) with exposures (race/ethnicity, insurance status, and language for care) using univariate and multivariable conditional logistic regression.
Results |
Of 209 cases and 836 matched controls, most cases identified as white (42%), had public/no insurance (66%), and were English-speaking (81%); most controls identified as white (53%), had private insurance (54%), and were English-speaking (90%). In univariate analysis, patients identifying as Black (OR: 2.79, 95% CI: 1.57, 4.95; P < .001), Hispanic (OR: 1.92, 95% CI: 1.24, 2.97; P = .003), with public/no insurance (OR: 2.21, 95% CI: 1.58, 3.10; P < .001), and using Spanish language for care (OR: 2.52, 95% CI: 1.47, 4.32; P < .001) had significantly increased odds of CEC, compared with patients identifying as white, using private insurance, and using English for care, respectively. In multivariable regression, Black race (adjusted OR: 2.12, 95% CI: 1.16, 3.87; P = .014) and public/no insurance (adjusted OR: 1.81, 95% CI: 1.22, 2.68; P = .003) remained significantly associated with receipt of CEC.
Conclusions |
We found disparities in receipt of CEC by race and insurance status. Further study is needed to determine the causes of these disparities.
Le texte complet de cet article est disponible en PDF.Keywords : bioethics, clinical ethics consultation, pediatrics, disparities, inequities
Abbreviations : BECA, CEC
Plan
| Conflict of Interest Disclosures: The authors have no conflicts of interest relevant to this article to disclose. |
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| Funding/Support: The project was done with no specific support. Dr. Olszewski wrote the first draft of the manuscript and no honorarium, grant, or other form of payment was provided for this work. |
Vol 258
Article 113415- juillet 2023 Retour au numéro
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