Racial and Ethnic Differences in Length of Stay for US Children Hospitalized for Acute Osteomyelitis

Campbell, Jeffrey I.; Shanahan, Kristen H; Bartick, Melissa; Ali, Mohsin; Goldmann, Don; Shaikh, Nadia; Allende-Richter, Sophie

doi:10.1016/j.jpeds.2023.113424

Cited by 3 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An important publication that did not meet criteria requires specific mention here, reporting increased LOS associated with specific ethnic groups. Campbell et al found that according to the US national database, children of Black or Hispanic ethnicity experienced significantly longer LOS than White children 28 . No subgroup analysis was undertaken to propose a cause for this, although the authors cite access to care and structural racism as potential drivers of inequity.…”

Section: Resultsmentioning

confidence: 99%

Methods to Reduce Cost of Treatment in Childhood Bone and Joint Infection

Hunter,

Crawford,

et al. 2024

JBJS Reviews

View full text Add to dashboard Cite

Background: Childhood bone and joint infection (BJI) is a potentially severe disease with consequences for growth and development. Critically unwell children may require prolonged hospitalization and multiple surgeries. Acknowledging rising healthcare costs and the financial impact of illness on caregivers, increased efforts are required to optimize treatment. This systematic review aims to characterize existing costs of hospital care and summarize strategies, which reduce treatment expense. Methods: A systematic review of the literature was performed from January 1, 1980, to January 31, 2024. Data were extracted on hospitalization costs for pediatric BJI by decade and global region. Results have been converted to cost per day in US dollars with purchase parity for 2023. Studies reporting innovations in clinical care to reduce length of stay (LOS) and simplify treatment were identified. Studies trialing shorter antibiotic treatment were only included if they specifically reported changes in LOS. Results: Twenty-three studies met inclusion criteria; of these, a daily hospitalization cost could be derived from 7 publications. Overall hospitalization cost and inpatient charges rose steeply from the 1990s to the 2020s. By contrast, average LOS seems to have decreased. Cost per day was higher in the United States than in Europe and higher for cases with confirmed methicillin-resistant Staphylococcus aureus. Sixteen studies report innovations to optimize care. For studies where reduced LOS was achieved, early magnetic resonance imaging with immediate transfer to theater when necessary and discharge on oral antibiotics were consistent features. Conclusion: Rising costs of hospital care and economic consequences for families can be mitigated by simplifying treatment for childhood BJI. Hospitals that adopt protocols for early advanced imaging and oral antibiotic switch may provide satisfactory clinical outcomes at lower cost. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract

Section: Resultsmentioning

confidence: 99%

Methods to Reduce Cost of Treatment in Childhood Bone and Joint Infection

Hunter,

Crawford,

et al. 2024

JBJS Reviews

View full text Add to dashboard Cite

show abstract

“…Lower socioeconomic status (SES) has been linked to delays in accessing MSK care, a concern especially relevant in pediatric orthopedics [ 7 ]. Studies have highlighted how delayed surgery and residence in rural areas can lead to adverse outcomes, particularly in cases of osteomyelitis [ 8 , 9 ]. While previous research has explored disparities in general MSK disorders, there remains a gap in understanding their specific impact on the characteristics and treatment outcomes of MSK infections in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%