Related Experiment Video
Updated: Aug 15, 2025
Making MR Imaging Child's Play - Pediatric Neuroimaging Protocol, Guidelines and Procedure
Published on: July 30, 2009
Racial and insurance status disparities in imaging modality among pediatric patients diagnosed with appendicitis
Jasmine Lemmons1, Ebubechi Adindu1, Michael Igwe1
1Center of Excellence in Health Equity, Training, and Research, Baylor College o Medicine, Houston, TX, USA.
Insights
Racial and insurance disparities exist in diagnostic imaging for pediatric appendicitis. Hispanic children and those with non-private insurance received different imaging modalities, impacting appendicitis diagnosis.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Radiology
Background:
- Diagnostic imaging is crucial for appendicitis diagnosis in children.
- Limited research exists on racial/ethnic and insurance disparities in pediatric appendicitis imaging.
- This study addresses these disparities in emergency department settings.
Purpose of the Study:
- To determine if race/ethnicity and insurance status are associated with imaging modality selection for pediatric appendicitis.
- To identify potential disparities in diagnostic imaging for appendicitis in children.
- To inform equitable healthcare practices in pediatric emergency care.
Main Methods:
- Retrospective cohort study using National Hospital Ambulatory Medical Care Survey (NHAMCS) data (2010-2019).
- Included children under 18 with appendicitis diagnosis (ICD-9-CM/ICD-10-CM).
- Analyzed associations between race/ethnicity, insurance status, and imaging modality using logistic regression.
Main Results:
- Hispanic children had higher odds of ultrasound and lower odds of X-ray or CT scans.
- Male patients were more likely to receive CT scans than females.
- Children with non-private/non-Medicaid/non-Medicare insurance were more likely to receive X-rays.
Conclusions:
- Significant racial/ethnic disparities in imaging modality selection for pediatric appendicitis were observed.
- Insurance status also plays a role in the type of imaging used for diagnosis.
- Findings highlight the need to address inequities in diagnostic imaging for pediatric appendicitis.
Background:
Studies have assessed the type of diagnostic imaging used in the treatment of appendicitis in children. Few studies investigated racial/ethnic and insurance disparities in imaging modalities used in pediatric patients diagnosed with appendicitis. Our study seeks to determine whether race/ethnicity and insurance status are associated with imaging modality chosen for pediatric patients diagnosed with appendicitis in the emergency department.
Methods:
This was a retrospective cohort study utilizing data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2010 to 2019. We included children <18 years old with a ICD-9-CM and ICD-10-CM diagnosis of appendicitis. Exposures were patient race/ethnicity and insurance status. Outcome of interest was imaging modality. We conducted adjusted survey logistic regression to evaluate the patient characteristics and receipt each of the imaging modalities among those with a diagnosis of appendicitis.
Results:
Of 308,140,115 emergency department (ED) visits, 1,126,865 (0.37%) had a diagnosis of appendicitis. Overall, male patients were more likely to receive CAT scan in comparison to female children (OR=2.52, 95% CI= 1.16-5.49). Additionally, Hispanic children who had significantly greater odds of obtaining ultrasound (OR= 4.56, 95% CI=1.09-19.12). Hispanic children were also less likely to receive x-ray (OR= 0.31, 95% CI=0.11-0.89) or computed tomography (CT) scans (OR= 0.23, 95% CI=0.07-0.76). Children diagnosed with appendicitis who had insurance other than private, Medicare, Medicaid, or self-pay were significantly more likely to receive x-ray studies (OR=4.39, 95% CI= 1.23-15.69).
Conclusions And Global Health Implications:
This study demonstrated the presence of racial/ethnic and insurance status disparities in the imaging modality chosen to assist in diagnosing appendicitis in pediatric patients.
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:24X-ray Imaging
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:30Radiological Investigation I: X-ray and CT