Ethnic Disparities in the Management of Pediatric Subcutaneous Abscesses

Area of Science:

• Pediatric Emergency Medicine
• Health Disparities Research
• Surgical Care Access

Background:

• Racial and ethnic disparities significantly influence healthcare access in the US, particularly for pediatric emergency and surgical services.
• Existing disparities necessitate an examination of their role in managing common pediatric conditions like subcutaneous abscesses.

Purpose of the Study:

• To investigate the impact of race and ethnicity on the diagnosis and management of pediatric subcutaneous abscesses.
• To identify potential disparities in treatment pathways and procedural interventions for pediatric patients presenting with subcutaneous abscesses.

Main Methods:

• Retrospective chart review of pediatric patients (<18 years) with subcutaneous abscesses treated in the Emergency Department (ED) over a 12-month period.
• Analysis of self-reported race and ethnicity (Hispanic vs. non-Hispanic, and specific racial groups) to assess effects on diagnosis and management.
• Comparison of treatment prior to ED visit, admission rates, incision and drainage (I&D) location, procedural sedation use, and patient outcomes (recurrence, re-admission).

Main Results:

• 192 pediatric patients were identified; 43.8% were Hispanic.
• Non-Hispanic patients were more likely to receive pre-ED treatment and hospital admission compared to Hispanic patients.
• No significant differences in bedside vs. operating room I&D or patient outcomes were observed; however, non-Hispanic patients received more procedural sedation for bedside I&D.

Conclusions:

• The study confirms the existence of racial and ethnic disparities in the management of pediatric subcutaneous abscesses within the US healthcare system.
• Factors such as access to tertiary care facilities and unconscious bias require further investigation to understand and address these disparities.
• While immediate management and outcomes showed no difference, disparities in treatment pathways highlight the need for systemic improvements in pediatric care delivery.