To identify sociodemographic factors associated with pediatric clinical ethics consultation (CEC). We hypothesized CEC would be higher among Black patients, patients with public/no insurance, and those using language interpretation.
Matched, case-control study at a single-center, tertiary pediatric hospital in the Pacific Northwest. Cases (patients hospitalized January 2008 to December 2019 with CEC) were compared with controls (those without CEC). We determined the association of the outcome (CEC receipt) with exposures (race/ethnicity, insurance status, and language for care) using univariate and multivariable conditional logistic regression.
Of 209 cases and 836 matched controls, most cases identified as white (42%), had public insurance (66%), and were English-speaking (81%); most controls identified as white (53%), had private insurance (54%), and were English-speaking (90%). In univariate regression, patients identifying as Black (odds ratio [OR]: 2.79, 95% confidence interval [CI]: 1.57, 4.95; P<.001), Hispanic (OR: 1.92, 95% CI: 1.24, 2.97; P=.003), with public/no insurance (OR: 2.21, 95% CI: 1.58, 3.10; P<.001), and using Spanish language for care (OR: 2.52, 95% CI: 1.47, 4.32; P<.001) had significantly increased odds of CEC, compared with patients identifying as white, using private insurance, and using English for care, respectively. In multivariable regression, Black race (adjusted OR [aOR]: 2.12, 95% CI: 1.16, 3.87; P=.014) and public or no insurance (aOR: 1.81, 95% CI: 1.22, 2.68; P=.003) remained significantly associated with receipt of CEC.
We found disparities in receipt of CEC by race and insurance status. Further study is needed to determine the causes of these disparities.

Published by Elsevier Inc.