Racial/ethnic disparities in management of acute gastroenteritis in a pediatric emergency department
Abstract
Gastroenteritis is one of the most commonly managed conditions in a pediatric emergency department (ED).1 Although the majority of cases require little diagnostic and/or therapeutic interventions, there is clinical variability in how patients with suspected gastroenteritis are managed.2 Such variability in clinical decision making is likely due to patient and systemlevel factors. Disparities in the emergency management of children have been noted across multiple clinical conditions.3,4 We sought to measure racial/ethnic differences in diagnostic testing and therapeutic interventions among patients diagnosed with gastroenteritis. We hypothesize that nonHispanic (NH) Black and Hispanic children diagnosed with gastroenteritis are less likely to undergo diagnostic testing and receive therapeutic interventions compared to NHWhite children. We performed a retrospective, crosssectional analysis of ED visits to an urban, tertiary care, freestanding children's hospital from January 1, 2016, to December 31, 2018. The study included all encounters for patients ≤18 years, who were discharged from the ED with a final International Classification of Diseases, Tenth Revision (ICD 10) diagnosis of gastroenteritis/gastropathy (K52.9) or infectious gastroenteritis and colitis, unspecified (A09, A08.4). Patients who were admitted to the hospital, who had an Emergency Severity Index (ESI) of level 1 or level 2, or who returned to the ED within 3 days of their initial presentation were excluded.…
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