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An Examination of Disparities in Pediatric Pain Management Centered on Socioeconomic Factors and Hospital Characteristics.

An Examination of Disparities in Pediatric Pain Management Centered on Socioeconomic Factors and Hospital Characteristics.
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Chiao FB, Wang A,


Chiao FB, Wang A, (click to view)

Chiao FB, Wang A,

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Journal of racial and ethnic health disparities 2017 02 08() doi 10.1007/s40615-017-0343-3
Abstract
INTRODUCTION
Very little is known about pediatric pain management resource differences. In contrast, disparities in pain management within the adult population are known to exist. This research examined whether significant differences exist between hospitals in the state of New York and what factors impact these pain resources.

METHODS
The study was approved by the institutional review board. A questionnaire was sent to the anesthesia/pediatric/pain directors of every hospital in the state of New York via SurveyMonkey. Poverty-enriched areas were identified based on the Census Bureau definition of poverty-enriched areas. The Chi-square test or Fisher exact test was used. Analyses were conducted to compare hospitals with and without a pediatric pain service (PPS) on several hospital characteristics. All analyses were in SAS-V9.4.

RESULTS
Of 160 physicians contacted, 40 completed the survey. Twenty-five percent reported that their hospital had a PPS. In these hospitals, 60% were separate from the adult pain service and 90% performed neuraxial but 30% did not offer more specialized nerve blocks. Socioeconomic status in which the hospital is situated did not impact the likelihood of having a PPS. PPSs were significantly more likely to be present in academic centers (p = 0.05) and children’s hospitals (p = 0.01). Rural hospitals were least likely to have a PPS (0%).

CONCLUSION
A minority of hospitals have a PPS and disparity exists. The results indicate to us that targeting rural areas and community hospitals for enhancement of PPS would be valuable. Additional teaching of peripheral nerve blocks would also be valuable.

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