Citation

Garg A, Lobner K, Song J, Mitchell R, Egbunine A, Kudchadkar SR. J. Pediatr. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.jpeds.2023.113459

PMID

37172806

Abstract

OBJECTIVE: To examine the current evidence regarding health care disparities in pediatric rehabilitation after hospitalization with traumatic injury. STUDY DESIGN: This systematic review utilized both PubMed and EMBASE, and each were searched with key MESH terms. Studies were included in the systematic review if they 1) addressed social determinants of health including, but not limited to, race, ethnicity, insurance status, and income level; 2) focused on inpatient and outpatient rehabilitation services post hospital stay; 3) were based in the pediatric population; and 4) addressed traumatic injury requiring hospitalization. Only studies from within the United States were included.

RESULTS: From 10,169 studies identified, 455 abstracts were examined for full-text review, and 24 studies were chosen for data extraction. Synthesis of the 24 studies revealed three major themes: 1) access to services; 2) outcomes from rehabilitation; and 3) service provision. Patients with public insurance had decreased availability of service providers and had longer outpatient wait times. Non-Hispanic Black and Hispanic children were more likely to have greater injury severity and decreased functional independence after discharge. Lack of interpreter services was associated with decreased utilization of outpatient services.

CONCLUSIONS: This systematic review identified significant effects of health care disparities on the rehabilitation process in pediatric traumatic injury. Social determinants of health must be thoughtfully addressed to identify key areas of improvement for the provision of equitable health care.

Language: en

Keywords

Social determinants of health; rehabilitation; pediatrics; health disparities; therapy