VCOM Carolinas Research Day 2023
Disparities between Demographics in Pediatric Prescriptions and Diagnoses in Latin America Dakota Becker-Greene, OMS-II 1 , Alyssa DeMutis, OMS-III 1 , Mandy Stallard, OMS-III 1 , Cameron Sumpter 2 , Harold R Garner, PhD 2 , Mayra Rodriguez, PhD, MPH 3
1 Edward Via College of Osteopathic Medicine, Carolinas Campus, Spartanburg, SC 2 Edward Via College of Osteopathic Medicine, Virginia Campus, Blacksburg, VA 3 Edward Via College of Osteopathic Medicine, Auburn Campus, Auburn, AL
Abstract # CLIN-8
Introduction This study utilized a retrospective chart review approach of 51,788 total patient encounters tracked through the CREDO logging system. The primary goal was to establish if there was any variability in the resources and care allocated to different age groups or clinic sites within the 3 Latin American countries that Edward Via College of Osteopathic medicine travels to during international outreach trips. This was achieved by stratifying the encounters by age group and country, then comparing the number of diagnoses and prescriptions between male and female pediatric patients. Short-term medical service trips (MSTs) are ubiquitous among U.S. medical schools, with trips typically ranging from 7-14 days in duration with the goal of addressing the unmet healthcare needs of developing countries. While these programs garner around $250 million in funding annually, little research has been conducted to analyze the types of care provided by MSTs and to examine their overall impact on community health within the pediatric populations of the countries they serve. Objectives 1) Determine if there is an association between demographics in Latin America and the number of medical diagnoses 2) Understand if there is an association between pediatric demographics in Latin America and the number of prescriptions
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Figure 4. Number of diagnoses (left) and prescriptions (right) amongst 3 unt ies a ed etween ale and e ale atients (Student’s t -test, ****p<0.001). Conclusion
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Age correlation data with number of diagnoses matches what was hypothesized, as children's immune system builds up over time, necessitating fewer visits and diagnoses as a result.
Figure 1. Distribution of demographic data from all encounters included between 01/2019 – 06/2022.
Prescriptions being positively correlated with age was an unexpected finding and will require further analysis.
References Adolescent males in the >11 year old group having more prescriptions on average highlights the gender disparity in pediatric care provided by MSTs. The increased number of diagnoses in male vs. female patients in El Salvador highlights an area of need where more outreach funding and supplies could be directed. Taken together, this data demonstrates the importance of monitoring MSTs in order to ensure equal and equitable distribution of care and resources.
Figure 2. Pearson correlation comparing age with number of diagnoses (left) and prescriptions (right). **shows correlation significance at 0.001 level. (2-tailed).
51,793 total patient encounters were utilized from the CREDO logging system who were seen between 01/2019 - 06/2022 and <18 years old
Patients included were treated at clinics in either Honduras, Dominican Republic, or El Salvador
All patient data was analyzed to understand the distribution of gender, number of prescriptions and diagnoses amongst all encounters Encounter data was grouped by both age (<1 month, 1-23 months, 2 11 years, and >11 years) and country (Honduras, Dominican Republic, and El Salvador) 2-tailed Pearson correlation and two- tailed Student’s t -test were used for all comparative analyses using SPSS IBM software
References & Acknowledgements
1. Maki J, Qualls M, White B, Kleefield S, Crone R. Health impact assessment and short-term medical missions: a methods study to evaluate quality of care. BMC Health Serv Res. 2008;8:121. doi:10.1186/1472-6963-8-1212 2. Job KM, Gamalo M, Ward RM. Pediatric Age Groups and Approach to Studies. Therapeutic Innovation & Regulatory Science. 2019;53(5):584-589. doi:10.1177/21684790198565724 Project approved under [1821431-2] Clinical Rotation Evaluation and Documentation Organizer - Electronic Clinical Records (CREDO ECR) through the Edward Via College of Osteopathic Medicine (VCOM) Institutional Review Board (IRB) on November 8 th , 2021.
Figure 3. Number of diagnoses (left) and prescriptions (right) amongst 4 a e u s a ed etween ale and e ale atients (Student’s t test, ****p<0.001).
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