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Current trends in racial, ethnic, and healthcare disparities associated with pediatric cardiac surgery outcomes

Jennifer K. Peterson1, Yanjun Chen2, Danh V. Nguyen3, Shaun P. Setty1

1 Long Beach Memorial Hospital/Miller Children’s and Women’s Hospital, Long Beach, California, USA
2 Biostatistics, Epidemiology, and Research Design Unit, University of California, Irvine, California, USA
3 Department of Medicine, University of California, Irvine School of Medicine, Orange, California, USA

* Corresponding Author: Shaun P. Setty, 2801 Atlantic Avenue, Long Beach, CA 90806. Email: email

Congenital Heart Disease 2017, 12(4), 520-532. https://doi.org/10.1111/chd.12475

Abstract

Objective: Despite overall improvements in congenital heart disease outcomes, racial and ethnic disparities have continued. The purpose of this study is to examine the effect of race and ethnicity, as well as other risk factors on congenital heart surgery length of stay and in-hospital mortality.
Design: From the 2012 Healthcare Cost and Utilization Project Kids Inpatient Database (KID), we identified 13 130 records with Risk Adjustment in Congenital Heart Surgery complexity scoreeligible procedures. Multivariate logistic and linear regression modeling with survey weights, stratification and clustering was used to examine the relationships between predictor variables and length of stay as well as in-hospital mortality.
Results: No significant mortality differences were found among all race and ethnicity groups across each age group. Black neonates and black infants had a longer length of stay (neonatal estimate = 8.73 days, P = .0034; infant estimate 1.10 days, P = .0253), relative to whites. Government-sponsored insurance was associated with increased odds of neonatal mortality (odds ratio = 1.51, P = .0055), increased length of stay in neonates (estimate = 4.26 days, P = .0009) and infants (estimate = 1.52 days, P = .0181), relative to private insurance. Government-sponsored insurance was associated with increased number of chronic conditions, which were also associated with increased LOS (estimate 8.39 days, P< .001 in neonates; estimate 3.60 days, P < .001 in infants; estimate 1.87 days, P < .001 children).
Conclusions: Racial/ethnic disparities in congenital heart surgical outcomes may be changing compared with previous studies using the KID database. Increased length of stay in children with government-sponsored insurance may reflect expansion of individual states governmentsponsored insurance eligibility criteria for children with complex chronic medical conditions. These findings warrant cautious optimism regarding racial and ethnic disparities in congenital heart surgery outcomes.

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Cite This Article

APA Style
Peterson, J.K., Chen, Y., Nguyen, D.V., Setty, S.P. (2017). Current trends in racial, ethnic, and healthcare disparities associated with pediatric cardiac surgery outcomes. Congenital Heart Disease, 12(4), 520-532. https://doi.org/10.1111/chd.12475
Vancouver Style
Peterson JK, Chen Y, Nguyen DV, Setty SP. Current trends in racial, ethnic, and healthcare disparities associated with pediatric cardiac surgery outcomes. Congeni Heart Dis. 2017;12(4):520-532 https://doi.org/10.1111/chd.12475
IEEE Style
J.K. Peterson, Y. Chen, D.V. Nguyen, and S.P. Setty, “Current trends in racial, ethnic, and healthcare disparities associated with pediatric cardiac surgery outcomes,” Congeni. Heart Dis., vol. 12, no. 4, pp. 520-532, 2017. https://doi.org/10.1111/chd.12475



cc Copyright © 2017 The Author(s). Published by Tech Science Press.
This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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