Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107137

Birgit Reime, DSc MPH, Dept. of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Ave, Vancouver, BC V6T 1Z3, Canada, (604) 806 9119, breime@cw.bc.ca, Andrew W. Tu, NAHBR, School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC V6T 1Z3, Canada, and Shoo Lee, MD PhD, Centre for Healthcare Innovation and Improvement, BC Research Institute for Children's and Women's Health, 4480 Oak Street E414A, Vancouver, BC V6H 3V4, Canada.

The aim of this study was to compare patient characteristics and treatments between Black and White infants in 17 Canadian neonatal intensive care units (NICUs). We examined 12,564 infants with information on ethnicity from 17 tertiary care NICUs across Canada from January 1996 to October 1997. Patient information included demographic variables, health status of infant and problems at birth, and standardized measures on illness severity (Score for Neonatal Acute Physiology Version II), and therapeutic intensity (Neonatal Therapeutic Intensity Scoring System [NTISS]). Patients were tracked until death or discharge home. Bivariate analyses and multivariable logistic regression models were conducted. Infants with other ethnicities than Black or White were excluded. Black infants (n=540) more often were born outside the NICU hospital, were older at admission, and had higher illness severity and treatment intensity scores than White infants (n=9,857). No differences were found regarding gender, birth mode, and mothers' prenatal care. In unadjusted models, the likelihood for seven treatments (surfactant, antenatal steroids, surgeries, blood transfusions, transparental nutrition, assisted ventilation, and incubator) was higher among Black than among White infants. After adjustment for health-related factors, neighbourhood characterisctics, and hospitals' treatment preferences, the differences in five of these treatments disappeared, but the likelihood for surfactant (OR=0.56;95%-CI=0.42,0.76) and antenatal steroid (OR=0.69;95%-CI=0.53,0.89) treatment became lower among Black than among White infants. Ethnic differences in treatment were explained by confounders in five out of seven treatments. Further studies should include additional variables to examine why Black infants have lower rates of particular treatments after adjustment for confounders.

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