Racial Disparities in the Emergency Department Evaluation of Adolescent Girls. Pediatr Emerg Care 2022 Jul 01;38(7):307-311
Date
03/31/2022Pubmed ID
35353799DOI
10.1097/PEC.0000000000002675Scopus ID
2-s2.0-85133214115 (requires institutional sign-in at Scopus site) 1 CitationAbstract
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
Author List
Polhemus S, Pickett ML, Liu XJ, Fraser R, Ferguson CC, Drendel ALAuthors
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of WisconsinRaphael Fraser PhD Assistant Professor in the Medicine department at Medical College of Wisconsin
Xuerong Liu Biostatistician II in the Institute for Health and Equity department at Medical College of Wisconsin
Michelle L. Pickett MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Abdominal PainAdolescent
Child
Emergency Service, Hospital
Female
Humans
Pregnancy
Retrospective Studies
Sexual Behavior
Sexually Transmitted Diseases
