{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:25:53Z","timestamp":1794018353330,"version":"4.8.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Healthcare disparities are widely described in adults, but barriers affecting access to care for pediatric patients with moyamoya disease (MMD) are unknown. Understanding socioeconomic factors impacting hospital access and outcomes is necessary to address pediatric healthcare disparities.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n In this cross-sectional observational study, the Kids\u2019 Inpatient Database was used to identify patients admitted with a primary diagnosis of MMD from 2003 to 2016. Patients \u2264 18 years with a primary diagnosis of MMD based on\n International Classification of Diseases<\/jats:italic>\n (ICD) codes were included. Hospital admissions were queried for use of cerebral revascularization based on ICD procedure codes.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Query of the KID yielded 1449 MMD hospitalizations. After multivariable regression, Hispanic ethnicity (OR 0.52 [95% CI 0.33\u20130.81], p = 0.004) was associated with lack of surgical revascularization. Private insurance (OR 1.56 [95% CI 1.15\u20132.13], p = 0.004), admissions at medium- and high-volume centers (OR 2.01 [95% CI 1.42\u20132.83], p < 0.001 and OR 2.84 [95% CI 1.95\u20134.14], p < 0.001, respectively), and elective hospitalization (OR 3.37 [95% CI 2.46\u20134.64], p < 0.001) were positively associated with revascularization. Compared with Caucasian race, Hispanic ethnicity was associated with increased mean (\u00b1 SEM) length of stay by 2.01 \u00b1 0.70 days (p = 0.004) and increased hospital charges by $24,333.61 \u00b1 $7918.20 (p = 0.002), despite the decreased utilization of surgical revascularization. Private insurance was associated with elective admission (OR 1.50 [95% CI 1.10\u20132.05], p = 0.01) and admission to high-volume centers (OR 1.90 [95% CI 1.26\u20132.88], p = 0.002). African American race was associated with the development of in-hospital complications (OR 2.52 [95% CI 1.38\u20134.59], p = 0.003).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Among pediatric MMD hospitalizations, multiple socioeconomic factors were associated with access to care, whether surgical treatment is provided, and whether in-hospital complications occur. These results suggest that socioeconomic factors are important drivers of healthcare disparities in children with MMD and warrant further study.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2022.1.peds21339","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T04:21:37Z","timestamp":1648182097000},"page":"602-611","source":"Crossref","is-referenced-by-count":5,"title":["Socioeconomic factors associated with pediatric moyamoya disease hospitalizations: a nationwide cross-sectional study"],"prefix":"10.3171","volume":"29","author":[{"given":"Kunal P.","family":"Raygor","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan R. 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