Objective
The aim of this study was to determine if race/ethnicity and socioeconomic status
(SES) were associated with the provision of anxiolysis and/or sedation among children
undergoing laceration repair.
Methods
A 1-year cross-sectional sample of children undergoing laceration repair in an urban
tertiary-care pediatric emergency department was analyzed. Primary outcomes included
the use of nonpharmacologic anxiolysis (presence of a child life specialist), pharmacologic
anxiolysis, and procedural sedation. Predictors included race/ethnicity (Caucasian
vs minority) and SES (represented by insurance status: private vs none/public). Bivariable
analyses provided unadjusted odds ratios (ORs) for the association between predictors
and outcomes, and logistic regression was used to obtain adjusted ORs for the provision
of anxiolysis and sedation (adjusted for age, gender, acuity, provider type, length
of laceration, complexity of repair, time of day, use of a topical anesthetic, and
body site of laceration).
Results
In the unadjusted analysis, a higher proportion of Caucasian children than minority
children received nonpharmacologic anxiolysis and sedation, and a higher proportion
of children with high SES received nonpharmacologic anxiolysis compared with children
of low SES. However, these associations were not statistically significant once potential
confounders were controlled in the adjusted analysis.
Conclusions
A very small proportion of children undergoing laceration repair at this single institution
received pharmacologic anxiolysis and/or procedural sedation. We did not demonstrate
racial/ethnic or socioeconomic disparities with respect to the management of procedure-related
anxiety in children.
Key Words
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References
- Disparities in health care: an overview.Acad Emerg Med. 2003; 10: 1155-1160
- Racial and ethnic disparities in the clinical practice of emergency medicine.Acad Emerg Med. 2003; 10: 1184-1188
- Smedley B.D. Stith A.Y. Nelson A.R. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Institute of Medicine of the National Academies, Washington, DC2003
Healthy People 2010. Leading health indicators. Available at: http://www.healthypeople.gov/LHI/. Accessed March 10, 2010.
- Race and sex differences in rates of invasive cardiac procedures in US hospitals. Data from the National Hospital Discharge Survey.Arch Intern Med. 1995; 155: 318-324
- Racial differences in the use of invasive cardiovascular procedures: review of the literature and prescription for future research.Ann Intern Med. 2001; 135: 352-366
- Racial and ethnic disparities in cardiac catheterization for acute myocardial infarction in the United States, 1995–2001.J Natl Med Assoc. 2005; 97: 317-323
- Racial variations in treatment and outcomes of black and white patients with high-risk non-ST-elevation acute coronary syndromes: insights from CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines?).Circulation. 2005; 111: 1225-1232
- Disparities in screening mammography. Current status, interventions and implications.J Gen Intern Med. 2004; 19: 184-194
- Socioeconomic status and risk for substandard medical care.JAMA. 1992; 268: 2383-2387
- Racial and ethnic disparities in health care for adolescents: a systematic review of the literature.Arch Pediatr Adolesc Med. 2003; 157: 867-874
- Racial and ethnic disparities in the primary care experiences of children: a review of the literature.Med Care Res Rev. 2003; 60: 3-30
- Racial and ethnic disparities in early childhood health and health care.Pediatrics. 2005; 115: e183-e193
- Parenteral analgesic and sedative use among ED patients in the United States: combined results from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 1992–1997.Am J Emerg Med. 2002; 20: 139-143
- Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments.JAMA. 2008; 299: 70-78
- Relief of pain and anxiety in pediatric patients in emergency medical systems.Pediatrics. 2004; 114: 1348-1356
- American Medical Association.Current Procedural Terminology. American Medical Association, Chicago, Ill2010
- Child life services.Pediatrics. 2006; 118: 1757-1763
Article Info
Publication History
Published online: April 12, 2010
Accepted:
December 3,
2009
Received:
January 5,
2009
Identification
Copyright
© 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
