Race, Socioeconomic Status Affect Outcomes in Pediatric Patients

The effects of race and socioeconomic status (SES) on outcomes in adult oncology patients has been well-described, but the effects on pediatric patients are less clear. A study presented during the 2021 ASCO Annual Meeting found that non-white race and lower SES were associated with mortality in pediatric oncology patients.

The Kids’ Inpatient Database was queried for data on inpatient stays for pediatric patients aged 20 years or younger between 2006 and 2012. The researchers evaluated discharge status, patient demographics, hospital characteristics, expected payment source, total visit charge, and length of stay. Initial comparisons were made between cancer and non-cancer inpatient stays. Patients were stratified by white, Black, Hispanic, Asian/Pacific Islander, and Native American/other race.

A total of 9,488,477 non–cancer-related pediatric inpatient stays and 242,489 cancer-related stays were identified. The cancer group was more likely to be white, male, and older at admission, as well as have private insurance and be from a higher income quartile. The cancer group, compared to the non-cancer group, had a higher rate of death during admission (1.2% vs. 0.5%), higher cost of visit charge ($25,097 vs. $8,267), longer length of stay (4 vs. 2 days), and lower rate of discharge (85.5% vs. 92.0%).

Among patients with cancer, the most common diagnoses were leukemia (n=75,807), other/unspecified primary (n=50,076), bone/connective tissue tumor (n=42,477), and central nervous system tumor (n=27,958). Non-white patients, compared to white patients, had higher odds of death during their inpatient stay (1.5% vs. 0.9%). Factors associated with higher odds of death during admission were Black race,  Native American race and lower income quartile.