Citation

Elliott LE, Gittelman MA, Kurowski EM, Duma EM, Pomerantz WJ. Inj. Epidemiol. 2023; 10(Suppl 1): e31.

Copyright

(Copyright © 2023, The author(s), Publisher Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s40621-023-00441-w

PMID

37400912

Abstract

BACKGROUND: Studies have illustrated racial and socioeconomic disparities in evaluation of non-accidental trauma (NAT). We aimed to investigate how implementation of a standardized NAT guideline in a pediatric emergency department (PED) impacted racial and socioeconomic disparities in NAT evaluation.

RESULTS: 1199 patients (541 pre- and 658 post-guideline) were included for analysis. Pre-guideline, patients with governmental insurance were more likely than those with commercial insurance to have a social work (SW) consult completed (57.4% vs. 34.7%, p < 0.001) and a Child Protective Services (CPS) report filed (33.4% vs. 13.8%, p < 0.001). Post-guideline, these disparities were still present. There were no differences in race, ethnicity, insurance type, or social deprivation index (SDI) in rates of complete NAT evaluations pre- or post-guideline implementation. Overall adherence to all guideline elements increased from 19.0% before guideline implementation to 53.2% after (p < 0.001).

CONCLUSION: Implementation of a standardized NAT guideline led to significant increase in complete NAT evaluations. Guideline implementation was not associated with elimination of pre-existing disparities in SW consults or CPS reporting between insurance groups.

Language: en

Keywords

Infant; Standardization; Disparities; Non-accidental trauma