Health Disparities in the Management and Outcomes of Critically Ill Children and Neonates: A Scoping Review

Area of Science:

• Pediatric Critical Care Medicine
• Health Services Research
• Health Equity

Background:

• Health disparities among critically ill children have primarily been examined within isolated intensive care unit (ICU) settings.
• This siloed approach hinders collaborative efforts crucial for advancing pediatric critical care.
• A comprehensive understanding across different pediatric ICU types is needed.

Purpose of the Study:

• To conduct a scoping review of the literature on health disparities in critically ill children.
• To specifically examine disparities across three primary ICU settings: neonatal ICU, pediatric ICU, and cardiac ICU within the United States.
• To identify common themes and gaps in the existing research.

Main Methods:

• Systematic search of relevant databases for studies published on health disparities in pediatric critical care.
• Inclusion of over 50 studies that explicitly investigated disparities.
• Categorization of disparities based on factors such as race/ethnicity, socioeconomic status, insurance, language, and geographic distance.

Main Results:

• The review identified numerous studies detailing health disparities in pediatric critical care.
• Disparities were documented across various demographic and socioeconomic factors including race/ethnicity, insurance status, socioeconomic position, language, and geographic distance.
• Significant variation exists in how these disparities are studied across neonatal, pediatric, and cardiac ICUs.

Conclusions:

• Existing research on health disparities in critically ill children is fragmented across different ICU settings.
• A cross-setting analysis reveals consistent disparities related to race/ethnicity, socioeconomic factors, and access to care.
• Future research and interventions should adopt a broader, cross-ICU perspective to effectively address child health inequities.