P0850 - Race and Income Affect Treatment of Common Pediatric Orthopaedic Fractures

INTRODUCTION
A fracture is one of the most common reasons pediatric patients present to the emergency department. Healthcare providers aim to deliver equal care to all patients regardless of race, ethnicity, or socioeconomic status. Despite the best intentions, healthcare disparities exist and allow for unequal and suboptimal care. This study aims to determine if the treatment modality for supracondylar humerus fractures is different based on race, ethnicity, or socioeconomic status.

METHODS
The New York Healthcare Cost and Utilization Project’s (HCUP) database was queried to evaluate all inpatient, ambulatory surgery, outpatient services, and emergency department encounters in 2016. Pediatric patients with supracondylar humerus fractures were identified by ICD-10 code. Treatment modality was determined by identifying the corresponding ICD-10 and/or CPT code. Race, ethnicity, payer information, and median income by zip code was identified and recorded. Standard descriptive statistical analysis was calculated.

RESULTS
A total of 1,192 patients with supracondylar humerus fractures were identified. Patients who were non-white were significantly more likely to receive non-operative treatment for a supracondylar humerus fractures (21% vs 11%, p<0.001). Patients with supracondylar humerus fractures from low-income zip codes were significantly more likely to receive non-operative treatment when compared to families from higher income zip codes (p<0.001).

DISCUSSION and CONCLUSION
Non-operative treatment of supracondylar humerus fractures was more common in non-white patients and in patients with lower socioeconomic status. These findings bring attention to healthcare disparities in our treatment of some of the most common pediatric orthopaedic fractures. Subsequent projects should focus on why these disparities exist so they can be eliminated. Shining light on these disparities allows us to increase our focus on providing equal and optimal care for all patients regardless of race, ethnicity, or socioeconomic status.