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Differences in testing for drugs of abuse amongst racial and ethnic groups at children's hospitals

Adriana Herrera1, Matt Hall2, Marshall Alex Ahearn1

  • 1Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Journal of Hospital Medicine
|February 22, 2024
PubMed

Insights

Black children were more likely to be drug tested in US children's hospitals than White children, particularly when hospitalized. These findings highlight potential healthcare disparities in pediatric drug testing.

Area of Science:

  • Pediatric Health Services Research
  • Health Disparities
  • Clinical Toxicology

Background:

  • Racial and ethnic disparities in drug testing are documented in adults and newborns.
  • Limited data exists on drug testing patterns for children and adolescents in healthcare settings.

Purpose of the Study:

  • To investigate the association between race/ethnicity and drug testing rates in children and adolescents in US children's hospitals.
  • To test the hypothesis that non-Hispanic White children are tested less frequently than other racial/ethnic groups.

Main Methods:

  • Retrospective cohort study of over 920,000 pediatric encounters (emergency department-only and hospitalizations) across 41 children's hospitals from 2018-2021.
  • Analysis compared drug testing rates among Asian, Black, Hispanic, and White children for conditions where testing may be indicated.
  • Rates were examined overall, by specific condition, patient cohort (ED-only vs. hospitalized), and across hospitals.

Main Results:

  • Overall, 13.6% of encounters involved drug testing.
  • Black children had significantly higher drug testing rates compared to White children (adjusted odds ratio [aOR]: 1.18).
  • This disparity was more pronounced in hospitalized children (aOR: 1.42) but not significant in emergency department-only encounters (aOR: 1.07). Asian and Hispanic children had similar testing rates to White children.

Conclusions:

  • Hospitalized Black children are more likely to undergo drug testing than White children in US children's hospitals.
  • Testing rates varied significantly by diagnosis and by hospital, indicating complex underlying factors.
  • Findings underscore the need to examine implicit bias and structural racism contributing to healthcare disparities in pediatric drug testing.
Abstract

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