Disparities in insurance status negatively affect patients with infantile hypertrophic pyloric stenosis

Daniel A. Reich, Genesys Giraldo, William Canty, Kelly M. Herremans, Janice A. Taylor, Shawn D. Larson, Robin Petroze, Saleem Islam

Research output: Contribution to journalArticlepeer-review


Purpose: Infantile hypertrophic pyloric stenosis (IHPS) is suspected to have worse outcomes when length of illness prior to presentation is prolonged. Our objective was to evaluate how social determinants of health influence medical care and outcomes for babies with IHPS. Methods: A retrospective review was performed over 10 years. Census data were used as proxy for socioeconomic status via Geo-Identification codes and correlated with food access and social vulnerability variables. The cohort was subdivided to understand the impact of Medicaid Managed Care (MMC). Results: The cohort (279 cases) was divided into two groups; early group from 2011 to 2015 and late from 2016 to 2021. Cases in the late group were older at the time of presentation (41.5 vs. 36.5 days; p = 0.022) and presented later in the disease course (12.8 vs. 8.9 days; p = 0.021). There was no difference in race (p = 0.282), gender (p = 0.874), or length of stay. Conclusions: Patients who presented with IHPS after implementation of phased MMC were older, had a longer symptomatic course, and shorter pylorus measurements. Patients with public insurance after the implementation of MMC were more likely to follow-up with an outpatient pediatrician within a month of hospitalization. These results suggest that MMC may have improved access to care for infants with IHPS.

Original languageEnglish
Article number127
JournalPediatric Surgery International
Issue number1
Publication statusPublished - Dec 2024
Externally publishedYes


  • Hypertrophic pyloric stenosis
  • Medicaid
  • Medicaid Managed Care disparity
  • Public insurance
  • Social determinants of health


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