Language Barriers in Care for Low-Risk Febrile Neonates

The management of febrile neonates has evolved as clinical evidence and disease epidemiology have instructed updated guidelines and practice patterns. While there has been extensive investigation of clinical determinants to identify neonates at low risk for invasive bacterial infection (IBI), there has been little investigation into the impact of sociodemographic characteristics on management of this population. The study by Gutman et al in JAMA Pediatrics examines the impact of race, ethnicity, and language for care on interventions performed for well-appearing febrile infants at low risk for IBI by clinical criteria in pediatric emergency departments (EDs). Among 4042 well-appearing, clinically low-risk febrile infants, 969 (24%) had at least 1 unnecessary intervention, such as lumbar puncture, antibiotic administration, and/or hospitalization. The investigators found that language for care was significantly associated with at least 1 nonindicated intervention in clinically low-risk neonates. Infants of families that use a language other than English (LOE) had higher odds of intervention overall (adjusted odds ratio  = 1.16 [95% CI, 1.01-1.33]) and of hospital admission (adjusted odds ratio = 1.25 [95% CI, 1.08-1.46]) when compared with the grand mean.
Source: JAMA Pediatrics - Category: Pediatrics Source Type: research