From the Division of Pediatric Surgery, Department of Surgery (M.B.L., D.J.H.), University of Minnesota, Minneapolis, Minnesota.
J Trauma Acute Care Surg. 2019 Mar;86(3):540-550. doi: 10.1097/TA.0000000000002160.
Health disparities are an increasingly researched topic in the United States. Evidence of disparities found across the spectrum of health care includes pediatric patients. The purpose of this review is to comprehensively summarize disparities among pediatric trauma patients, evaluating both emergency department and hospital treatment and outcomes. Multiple studies describe disparities in a variety of areas of trauma care including emergency department, radiology, surgery, abuse evaluation, and discharge rehabilitation. More concerning, multiple studies report disparities in length of stay, disability, recidivism, and mortality. This review also highlights several gaps in disparity research including specialty care, inclusion of all racial/ethnic groups, and geographic differences. Few of the reviewed studies described disparity interventions; however, research regarding abuse evaluations showed that care guidelines diminished disparity. Trauma care, a routinized patient service, is subject to existing care guidelines and quality improvement programs, and may be the ideal health care setting for disparity intervention. LEVEL OF EVIDENCE: Study type review, level V.
健康差异是美国日益研究的课题。在医疗保健的各个领域都发现了差异的证据，包括儿科患者。本综述的目的是全面总结儿科创伤患者的差异，评估急诊室和医院的治疗和结果。多项研究描述了急诊室、放射科、外科、虐待评估和出院康复等多个领域的差异。更令人担忧的是，多项研究报告了住院时间、残疾、复发和死亡率方面的差异。本综述还强调了差异研究中的几个差距，包括专业护理、纳入所有种族/族裔群体和地理差异。在被审查的研究中，很少有描述差异干预措施的研究；然而，关于虐待评估的研究表明，护理指南减少了差异。创伤护理是一种常规的患者服务，受现有护理指南和质量改进计划的约束，可能是差异干预的理想医疗保健环境。证据水平：研究类型综述，五级。
