Evidence map›Paper›PMID 38898210›Full record

ArticleSpine deformity2024

Socioeconomic differences in access to scoliosis care in the pediatric population.

Steven M Garcia, Kian Niknam, Faith Sumandea, Ishaan Swarup

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Article in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Steven M GarciaDepartment of Orthopaedic Surgery, University of California, San Francisco, 744 52nd Street, #1418, Oakland, CA, USA.
Kian NiknamDepartment of Orthopaedic Surgery, University of California, San Francisco, 744 52nd Street, #1418, Oakland, CA, USA.
Faith SumandeaSchool of Medicine, California Northstate University College of Medicine, Elk Grove, USA.
Ishaan SwarupDepartment of Orthopaedic Surgery, University of California, San Francisco, 744 52nd Street, #1418, Oakland, CA, USA. Ishaan.Swarup@ucsf.edu.ORCID 0000-0003-3481-3408

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAdolescent idiopathic scoliosis (AIS) is a common spinal deformity affecting pediatric patients, with up to 10% requiring surgical intervention. Studies have shown disparities in these patients associated with race, ethnicity, and insurance type, but there is limited information on disparities that exist based on geographical parameters. In this study, we aim to explore the disparities in the care for AIS by looking at differences in the rates of readmission, infection, and revision between patients residing in rural and urban environments.

methodsThis is a retrospective cohort study utilizing the Pediatric Health Information System. Pediatric patients that underwent posterior spinal fusion (PSF) for AIS from October 2015 to July 2022 were included. Diagnoses and procedures were identified based on ICD-10 codes and internal tools built into the database. Descriptive statistics were used to summarize the data, including demographics, infection rates, readmission rates, and revision rates. T tests, Chi-squared tests, and logistic regression were used to assess differences between the rural and urban populations. We utilized STATA/SE 15.1 for all data analysis.

results15,318 patients were included in the final cohort. Demographics and baseline characteristics were similar between the rural and urban patients, although more rural patients used Medicaid over commercial insurance (41.5% vs. 32.7%, p < 0.01), median household income was lower in rural patients (p < 0.01), and there was a higher proportion of Hispanic patients in the urban patient cohort (13.9% vs. 6.4%, p < 0.01). Complication rates were not significantly different between the urban and rural patient cohorts, although rural patients did have a significantly higher 90-day readmission rate (7.3% vs. 6.1%, p = 0.03) and higher rates of instrumentation removal (7.7% vs. 4.9%, p = 0.01).

conclusionsThe surgical outcomes between rural and urban pediatric AIS patients undergoing PSF are comparable, although 90-day readmission rates and rates of instrumentation removal were higher in rural patients. Insurance status is likely a significant driver for the differences observed in this study. Future research is needed to better understand the reasons for these differences and to develop strategies to improve outcomes. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.

Indexed as

Healthcare DisparitiesHealth Services AccessibilityPatient ReadmissionScoliosisSocioeconomic FactorsSpinal FusionAdolescentChildFemaleHumansMaleReoperationRetrospective StudiesRural PopulationUnited StatesUrban PopulationAccess to careAdolescent idiopathic scoliosisEvidence basedHealthcare equityPosterior spinal fusion

Identifiers

PMID38898210

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.