{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T23:01:20Z","timestamp":1781305280988,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["K23\u2010HL\u2010148539"],"award-info":[{"award-number":["K23\u2010HL\u2010148539"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["K24\u2010AR\u2010066109"],"award-info":[{"award-number":["K24\u2010AR\u2010066109"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Health disparities may be driven by hospital\u2010level factors. We assessed whether racial and ethnic composition of populations hospitals serve explain or modify disparities in hospital outcomes of children with systemic lupus erythematosus (SLE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective cohort study of patients 5 to 26 years old with SLE at 47 children's hospitals in the Pediatric Health Information System (2006\u20132021), race and ethnicity were assessed at the patient level and hospital level (proportion of total admissions composed of Black or Hispanic patients, respectively). Outcomes included intensive care unit (ICU) admission or adverse renal outcome (end\u2010stage renal disease, dialysis, or transplant) during follow\u2010up. We estimated racial and ethnic disparities, adjusted or stratified by hospital racial or ethnic composition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 8,125 patients with SLE, 2,293 (28%) required ICU admission, and 698 (9%) had an adverse renal outcome. Black and non\u2010Hispanic White disparities in ICU admission were observed only at hospitals serving higher proportions of Black patients (odds ratio [OR] 1.29, 95% confidence interval [95% CI] 1.04\u20131.59 vs OR 1.07, 95% CI 0.83\u20131.38). Larger Black and non\u2010Hispanic White disparities in adverse renal outcomes were observed at hospitals with higher Black racial composition (OR 2.0, 95% CI 1.4\u20132.8 vs OR 1.7, 95% CI 1.1\u20132.4). Conversely, Hispanic versus non\u2010Hispanic disparities in renal outcomes persisted after adjustment for hospital\u2010reported Hispanic ethnic composition but were observed only at hospitals with lower proportions of Hispanic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Worse Black and White disparities in SLE outcomes are observed at children's hospitals serving more Black children, whereas distinct patterns are observed for Hispanic and non\u2010Hispanic disparities. Reporting of hospital characteristics related to populations served is needed to identify modifiable drivers of hospital\u2010level variation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25314","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:12:19Z","timestamp":1708387939000},"page":"926-935","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Racial and Ethnic Composition of Populations Served by Freestanding Children's Hospitals and Disparities in Outcomes of Pediatric Lupus"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1691-4814","authenticated-orcid":false,"given":"Joyce C.","family":"Chang","sequence":"first","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica P.","family":"Liu","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.","family":"Berbert","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2223-0061","authenticated-orcid":false,"given":"Mia T.","family":"Chandler","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja N.","family":"Patel","sequence":"additional","affiliation":[{"name":"Lurie Children's Hospital and Northwestern University  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6226-9265","authenticated-orcid":false,"given":"Emily A.","family":"Smitherman","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edie A.","family":"Weller","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Beth F.","family":"Son","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8972-9388","authenticated-orcid":false,"given":"Karen H.","family":"Costenbader","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40512"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42127"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.8.1212"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3549(04)50068-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0020731420937632"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.11.1177"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.12.1233"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.2215"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1640"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2023-007195"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-7295.1997.tb01920.x"},{"key":"e_1_2_7_13_1","volume-title":"American Apartheid: Segregation and the Making of the Underclass","author":"Massey DS","year":"1993"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302955"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-018-0272-4"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.33710"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.12842"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318041f723"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00305"},{"key":"e_1_2_7_20_1","unstructured":"Comparative analysis of GME funding programs for children's hospitals and general acute care teaching hospitals.Dobson DaVanzo & Associates LLC.2022. 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