A new study has uncovered concerning racial and ethnic disparities in how hospitals implement recent guidelines for managing fever in young infants. The research, published in Pediatrics, examined adherence to 2021 American Academy of Pediatrics (AAP) guidelines across 103 hospitals, revealing unintended consequences in equitable care delivery.
The study of 16,961 infants found that while there were no differences in primary measures like appropriate use of lumbar punctures or antibiotic prescriptions, disparities emerged in secondary measures. White infants were more likely to have inflammatory markers obtained and documented follow-up recommendations upon emergency department discharge. In contrast, Hispanic/Latino infants were less likely to receive these interventions.
Most notably, both Black and Hispanic/Latino infants were significantly less likely to have documented shared decision-making regarding lumbar punctures and ED discharge – a key recommendation in the new guidelines. Dr. Corrie McDaniel, lead researcher from the University of Washington, expressed concern about this finding, stating, “What we discovered in this work, though, is potentially the risk for a fourth category — creating disparities that were not there at baseline.”
The results highlight the complex nature of implementing new clinical guidelines and their potential to inadvertently exacerbate health disparities. Dr. McDaniel emphasized the need for governing bodies to consider equity when developing recommendations, particularly for practices like shared decision-making that may be prone to bias in implementation. She stressed the importance of acknowledging these risks and providing additional resources to ensure equitable care for all infants, regardless of race or ethnicity.
See “Racial, ethnic disparities emerge in adherence to guidelines for infant fever” (August 29, 2024)