From the Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI.
Pediatr Emerg Care. 2022 Jul 1;38(7):307-311. doi: 10.1097/PEC.0000000000002675. Epub 2022 Mar 29.
Racial disparities and differences exist in emergency care. Obtaining a sexual history is standard of care for adolescents with abdominal pain. Testing for sexually transmitted infections (STIs) and pregnancy should be based on historical findings. The objective of this study was to determine whether differential care was provided to adolescent female patients with abdominal pain based on patient race or healthcare provider characteristics by evaluating the documentation of sexual history, STI testing, and pregnancy testing.
This was a retrospective chart review of female patients between the ages of 14 and 18 years with abdominal pain presenting to a pediatric emergency department. Patient and provider characteristics, sexual history documentation, STI, and pregnancy testing were abstracted. Data were analyzed using χ 2 test and logistic regression model.
Eight hundred eighty-six encounters were included in the analysis. Median patient age was 16 years (range, 14-18 years); 359 (40.5%) were non-White. Differential care was provided. Non-White patients compared with White patients were more likely to have a documented sexual history (59.9% vs 44.0%, P < 0.001), STI testing (24.8% vs 7.8%, P < 0.001), and pregnancy testing (76.6% vs 66.2%, P < 0.001). Among sexually active female patients, the racial disparity for STI testing persisted ( P = 0.010). Provider type and sex did not result in differences in sexual history documentation, STI, or pregnancy testing for non-White compared with White patients ( P > 0.05).
Differential care was provided to non-White adolescents with abdominal pain compared with White adolescents. They were more likely to have a documented sexual history, STI testing, and pregnancy testing. Healthcare provider characteristics did not impact patient care. This racial disparity resulted in better medical care for non-White adolescents, but this may be the consequence of underlying implicit bias.
在急救护理中存在种族差异和差异。获取性病史是腹痛青少年的护理标准。性传播感染（STI）和妊娠检测应基于病史发现。本研究的目的是通过评估性病史、性传播感染检测和妊娠检测的记录，确定基于患者种族或医疗保健提供者特征是否为腹痛的青少年女患者提供不同的护理。
这是一项对儿科急诊科就诊的 14 至 18 岁腹痛女性患者的回顾性病历回顾。提取患者和提供者特征、性病史记录、性传播感染和妊娠检测。使用卡方检验和逻辑回归模型分析数据。
共纳入 886 例就诊。中位患者年龄为 16 岁（范围，14-18 岁）；359 例（40.5%）为非白人。提供了差异化护理。与白人患者相比，非白人患者更有可能记录性病史（59.9%对 44.0%，P <0.001）、性传播感染检测（24.8%对 7.8%，P <0.001）和妊娠检测（76.6%对 66.2%，P <0.001）。在有性行为的女性患者中，性传播感染检测的种族差异仍然存在（P = 0.010）。与白人患者相比，提供者类型和性别并未导致非白人患者的性病史记录、性传播感染或妊娠检测存在差异（P > 0.05）。
与白人青少年相比，非白人青少年腹痛患者接受了差异化护理。他们更有可能有记录的性病史、性传播感染检测和妊娠检测。医疗保健提供者的特征并未影响患者护理。这种种族差异导致非白人青少年获得了更好的医疗护理，但这可能是潜在的隐性偏见的结果。
