Racial and Ethnic Disparities in Management of Gastroenteritis in a Pediatric Emergency Department

Racial and Ethnic Differences in Ondansetron Use for Acute Gastroenteritis in Children

“…Although our study did not examine differences in diagnostic workup, a single-center study found that Hispanic patients with AGE were less likely to have laboratory or imaging studies performed than NHW patients 35 . Another single-center study also found that minority patients were less likely to receive imaging or laboratory studies and that Hispanic patients were less likely to receive IV fluid but found no differences in ondansetron use as compared with NHW patients 37 . Finally, the most robust single-center study to date found that children of all minority groups were less likely to receive IV fluids or hospital admission but found that only patients of non-Black NH race/ethnicity were more likely to receive ondansetron 36 .…”

“…However, single-center studies on this topic have found similar results even after adjusting for illness severity and language preference. 36,37 Furthermore, disparities in ED management remain critical to identify regardless of whether they represent management disparities at the bedside or population-level disparities in utilization of care such as delayed presentation or limited access to primary care. Another limitation is the possibility of bias in cohort selection.…”

“…35 Another single-center study also found that minority patients were less likely to receive imaging or laboratory studies and that Hispanic patients were less likely to receive IV fluid but found no differences in ondansetron use as compared with NHW patients. 37 Finally, the most robust single-center study to date found that children of all minority groups were less likely to receive IV fluids or hospital admission but found that only patients of non-Black NH race/ethnicity were more likely to receive ondansetron. 36 Our study validates these findings with similar results in a national sample of pediatric EDs.…”

“…Despite this increasing body of evidence, little is known about disparities in the emergency management of pediatric AGE. Existing research is limited to single-center studies that have suggested racial/ethnic differences in diagnostic testing, treatment, and disposition for children with AGE 35–37 . The purpose of this study was to examine racial/ethnic differences in the management of pediatric AGE using a national, multicenter database based on the hypothesis that there would be racial/ethnic differences in care provision for these patients.…”