Children who are Black or Hispanic have a relative higher risk of pneumonia after surgery than White children, and the disparities are taking both a health and economic toll, according to a new study.
“We provide these analyses to underscore the urgent need for measures to reduce surgical health disparities in children,” authors wrote in “Trends and Economic Implications of Disparities in Postoperative Pneumonia” (Mpody C, et al. Pediatrics. April 14, 2023).
Postoperative pneumonia, the third most common surgical complication, has been linked to increased hospital stays and a seven-fold higher risk of death, according to the study. The researchers from Nationwide Children’s Hospital set out to look at disparities in this condition using data on a nationally representative sample of just over 195,000 children who underwent a variety of elective surgeries at more than 5,000 U.S. hospitals from 2010-’18.
In 2010, 1.06% of Hispanic children, 0.95% of Black children and 0.82% of White children experienced postoperative pneumonia. Black children experienced about a 0.03 percentage point decline in their risk-adjusted rates each year, while White and Hispanic children each saw a decline of about 0.05 percentage points.
Researchers’ adjusted analyses showed that through the study period, Black children had a 31% relative higher risk of postoperative pneumonia than White children, while Hispanic children had a 16% relative higher risk than White children.
Authors said the differences are not biological but social, possibly caused by factors like health care disparities, language barriers and unconscious bias.
The findings that rates of postoperative pneumonia declined show that interventions have been successful and that future interventions should target racial disparities, authors said.
“Specific societal measures to improve access to care for minority children (a persistent feature of structural inequity) and active hospital surveillance measures designed to mitigate the occurrence of postoperative pneumonia in this population are urgently needed,” they wrote.
In addition, these disparities led to about $24.5 million in extra hospital costs for Black children and $26.2 million in extra hospital costs for Hispanic children across the study period.
“Our study and others on the economic costs of racial disparities indicate that ensuring equitable outcomes for everyone is not only morally right but it is also economically expedient,” authors wrote.