WIP 06 - Evaluating Racial and Language-Based Disparities in Left Without Being Seen Rates in a Pediatric ED During the “Tripledemic”

Publication Number: WIP 06.7508

Beverly Aiyanyor, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Nicole R. Harrington, University of Pennsylvania, Philadelphia, PA, United States; Naomi Hughes, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Tasha Ellison, Childrens Hospital of Philadelphia, Drexel Hill, PA 19026-2911, PA, United States; Joseph J. Zorc, Children's Hospital of Philadelphia, Wynnewood, PA, United States; Ashlee Murray, Perelman School of Medicine at the University of Pennsylvania, Haddon Township, NJ, United States

Background: The "tripledemic” – referring to overlapping waves of respiratory syncytial virus (RSV), influenza, and COVID-19—strained pediatric emergency departments (EDs) during the winter season of 2022. Increased patient volumes led to a surge in left without being seen (LWBS) cases, a metric associated with delays in diagnosis, treatment, and increased hospital admissions, as well as diminished patient satisfaction. Existing research in adult ED settings indicates racial and ethnic disparities in LWBS rates, with Black and Hispanic patients facing higher LWBS rates and longer wait times. However, less is known about LWBS disparities among pediatric populations, particularly concerning Black and non-English-speaking patients, during times of public health emergencies. This study aims to address these gaps by evaluating the racial and language-based differences in LWBS rates in a pediatric ED during the “tripledemic” period.

Objective: Determine differences in LWBS rates among pediatric patients from non-English-speaking families and by self-identified race, presenting to a pediatric emergency department during the "tripledemic" period.

Design/Methods: This study uses a retrospective observational design to examine electronic medical records (EMRs) for patients marked as LWBS between October 1st, 2022, and January 31st, 2023. Comparative data from September to December 2019 (pre-COVID) as well as data after the tripledemic is in the process of being collected, with the entire data set plan to encompass September 2022 to January 2024. Key demographic and clinical variables include self-identified race and ethnicity, language (spoken), sex, age, ESI, zip code, insurance type, time and date of visit, length of stay, chief complaint, and social vulnerability index. Data analysis will employ descriptive statistics, bivariate analysis, and multivariate logistic regression to identify disparities in LWBS rates. This study has been granted IRB exemption.