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Review
. 2023 Jul;108(7):518-524.
doi: 10.1136/archdischild-2022-324577. Epub 2022 Nov 7.

Ethnic differences and inequities in paediatric healthcare utilisation in the UK: a scoping review

Affiliations
Review

Ethnic differences and inequities in paediatric healthcare utilisation in the UK: a scoping review

Claire X Zhang et al. Arch Dis Child. 2023 Jul.

Abstract

Background: Despite the increased policy attention on ethnic health inequities since the COVID-19 pandemic, research on ethnicity and healthcare utilisation in children has largely been overlooked.

Objectives: This scoping review aimed to describe and appraise the quantitative evidence on ethnic differences (unequal) and inequities (unequal, unfair and disproportionate to healthcare needs) in paediatric healthcare utilisation in the UK 2001-2021.

Methods: We searched Embase, Medline and grey literature sources and mapped the number of studies that found differences and inequities by ethnic group and healthcare utilisation outcome. We summarised the distribution of studies across various methodological parameters.

Results: The majority of the 61 included studies (n=54, 89%) identified ethnic differences or inequities in paediatric healthcare utilisation, though inequities were examined in fewer than half of studies (n=27, 44%). These studies mostly focused on primary and preventive care, and depending on whether ethnicity data were aggregated or disaggregated, findings were sometimes conflicting. Emergency and outpatient care were understudied, as were health conditions besides mental health and infectious disease. Studies used a range of ethnicity classification systems and lacked the use of theoretical frameworks. Children's ethnicity was often the explanatory factor of interest while parent/caregiver ethnicity was largely overlooked.

Discussion: While the current evidence base can assist policy makers to identify inequities in paediatric healthcare utilisation among certain ethnic groups, we outline recommendations to improve the validity, generalisability and comparability of research to better understand and thereby act on ethnic inequities in paediatric healthcare.

Keywords: child health; health services research; healthcare disparities; paediatrics.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. NICE, National Institute for Health and Care Excellence.
Figure 2
Figure 2
Number of studies by whether the study found any ethnic variation, stratified by whether the study attempted to distinguish between difference and inequity.
Figure 3
Figure 3
Number of studies that found ethnic variation, stratified by ethnic group, healthcare utilisation outcome and whether the study examined ethnic differences or inequities. 3A shows studies that used aggregated ethnic groups. 3B shows studies that used disaggregated ethnic groups.

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