Disparities in Pediatric Specialty Referral

Journal of Pediatrics

Open Access Published: May 15, 2023DOI:https://doi.org/10.1016/j.jpeds.2023.113485

Anisha Srinivasan et al 

Disparities in Pediatric Specialty Referral 


To estimate differences in scheduled and completed specialty referrals by race, ethnicity, language for care, and insurance type.

Study design

We studied a retrospective cohort of 38 334 specialty referrals to a large children’s hospital between March 2019 and March 2021. We included referrals for patients with primary care clinics within 5 miles of the hospital. We examined whether the odds of and time to schedule and complete referrals differed by patient sociodemographic characteristics.


Of all referrals, 62% were scheduled and 54% were completed. Referral completion rates were lower for patients with Black race (45%).

Within a geographically homogenous pediatric population, the odds and time to schedule and complete specialty referrals differed by sociodemographic characteristics, suggesting the effects of discrimination. 

What Is Important: This is the kind of statistic that gets buried in the minutia. But it is blatantly obvious that Black children are not getting anywhere near equal quality care. 

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