Racial and Ethnic Composition of Populations Served by Freestanding Children's Hospitals and Disparities in Outcomes of Pediatric Lupus
Authors' conclusion
Worse Black and White disparities in SLE outcomes are observed at children's hospitals serving more Black children, whereas distinct patterns are observed for Hispanic and non-Hispanic disparities.
Study context
- Population
- Patients 5 to 26 years old with systemic lupus erythematosus (SLE) at 47 children's hospitals in the Pediatric Health Information System (2006–2021)
- Participants
- 8,125 patients
- Exposure
- Black vs non-Hispanic White and Hispanic vs non-Hispanic patients, stratified or adjusted by hospital racial or ethnic composition
- Outcome
- ICU admission or adverse renal outcome (end-stage renal disease, dialysis, or transplant) during follow-up
Methodological detailsmulticentre (47 children's hospitals), Pediatric Health Information System database
- Multicentre (47 children's hospitals)
- Pediatric Health Information System database
Main finding
As reported in the abstract
ICU admission, Black vs non-Hispanic White disparity by hospital Black composition
Black vs Non-Hispanic WhiteOdds ratio (95% CI)
Hospitals serving higher proportions of Black patients
1.29(1.04–1.59)
Hospitals serving lower proportions of Black patients
1.07(0.83–1.38)
- Intensive care unit (ICU) admission in whole cohort
- 2,293 (28%)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Adverse renal outcome, Black vs non-Hispanic White disparity by hospital Black compositionBlackvs Non-Hispanic WhiteHospitals with higher Black racial composition | 2.0 (1.4–2.8) | |
| Adverse renal outcome, Black vs non-Hispanic White disparity by hospital Black compositionBlackvs Non-Hispanic WhiteComparison hospitals (lower Black composition) | 1.7 (1.1–2.4) | |
| 0.20.5125Odds ratio (log scale) |
- Adverse renal outcome, Black vs non-Hispanic White disparity by hospital Black composition — Adverse renal outcome in whole cohort
- 698 (9%)
Adverse renal outcome, Hispanic vs non-Hispanic disparity
- Disparities persisted after adjustment for hospital-reported Hispanic ethnic composition but were observed only at hospitals with lower proportions of Hispanic patients
Original publication
Racial and Ethnic Composition of Populations Served by Freestanding Children's Hospitals and Disparities in Outcomes of Pediatric Lupus. Arthritis Care Res (Hoboken). Published 15 March 2024. doi:10.
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