{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T09:38:10Z","timestamp":1792834690486,"version":"4.5.0"},"reference-count":43,"publisher":"American Academy of Pediatrics (AAP)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND AND OBJECTIVES<\/jats:title>\n                    <jats:p>Racial and ethnic disparities disproportionately impact children with medical complexity (CMC), including children with tracheostomies. Children hospitalized for bacterial tracheostomy-associated infections (bTRAINs) experience care variations that may exacerbate disparities. Our study aimed to quantify disparities in length of stay (LOS) for children hospitalized with bTRAINs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a multicenter observational study of children aged 0 to 21\u00a0years who were hospitalized and treated for a bTRAIN at 6 children\u2019s hospitals between August 2020 and August 2024, excluding children with outlier LOS (&amp;gt;30\u00a0days). Our primary predictor was race and ethnicity, as documented in the electronic medical record. Our primary outcome was LOS (days). We used mixed-effects regression modeling to account for repeated encounters, nesting of patients within hospitals, and adjusting for confounders (socioeconomic factors, comorbidities and illness severity).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We included 662 children (39% white, 35% Hispanic, 22% Black, and 4% Asian) representing 1349 unique encounters. The median age at hospitalization was 6\u00a0years (IQR 2\u201313) and 72% of children had public insurance. Median LOS was 8\u00a0days (IQR 5\u201312). When adjusting for confounders, all other racial groups had longer LOS compared with white children with ratio of means of 1.14 (95% CI: 1.03\u20131.28) for Black; 1.12 (95% CI: 1.01\u20131.25) for Hispanic; and 1.29 (95% CI: 1.07\u20131.54) for Asian children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Black, Hispanic, and Asian children hospitalized for a bTRAIN experience longer LOS than white children. Understanding is needed on how implicit bias, systemic racism, and care-team preferences lead to disparities and if standardized care can improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2025-009114","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:02:32Z","timestamp":1784160152000},"page":"653-661","source":"Crossref","is-referenced-by-count":1,"title":["Racial and Ethnic Disparities in Length of Stay for Pediatric Bacterial Tracheostomy-Associated Infections"],"prefix":"10.1542","volume":"16","author":[{"given":"Margaret","family":"Rush","sequence":"first","affiliation":[{"name":"1Division of Hospital Medicine, Children\u2019s National Hospital Washington, District of Columbia"},{"name":"2Department of Pediatrics, George Washington University School of Medicine and Health Sciences Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilana","family":"Moffet","sequence":"additional","affiliation":[{"name":"3George Washington School of Medicine and Health Sciences Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Kono","sequence":"additional","affiliation":[{"name":"4Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Hahn","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, George Washington University School of Medicine and Health Sciences Washington, District of Columbia"},{"name":"5Division of Infectious Diseases, Children\u2019s National Hospital, Washington, District of Columbia"},{"name":"6Center for Precision Medicine and Genomics Research, Children\u2019s National Research Institute, Washington, District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Morrison","sequence":"additional","affiliation":[{"name":"7Division of Pediatric Hospital Medicine, Johns Hopkins All Children\u2019s Hospital, St. Petersburg, Florida"},{"name":"8Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Thomson","sequence":"additional","affiliation":[{"name":"9Division of Hospital Medicine and James M. Anderson Center for Health Systems Excellence, Cincinnati Children\u2019s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Cogen","sequence":"additional","affiliation":[{"name":"10Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children\u2019s Hospital, University of Washington, Seattle, Washington"},{"name":"11Department of Pediatrics, University of Washington\/Seattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine S.","family":"Forster","sequence":"additional","affiliation":[{"name":"12Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Neely","sequence":"additional","affiliation":[{"name":"13Division of Infectious Diseases, Children\u2019s Hospital Los Angeles, Los Angeles, California"},{"name":"14Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hofman DeYoung","sequence":"additional","affiliation":[{"name":"10Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children\u2019s Hospital, University of Washington, Seattle, Washington"},{"name":"11Department of Pediatrics, University of Washington\/Seattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhada V.","family":"Mairal","sequence":"additional","affiliation":[{"name":"15Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy 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