887. Race and ethnicity differences in hospital length of stay for children with acute osteomyelitis in the United States

Abstract Background Changes in management of bone infections, particularly early transition to oral antibiotic therapy, have decreased length stay (LOS) for children hospitalized with acute osteomyelitis. However, evaluation differences by race and ethnicity been limited. Methods Using the Kids’ Inpatient Database, we conducted a cross-sectional study ages 0–20 years 2016 or 2019 primary secondary diagnosis survey-weighted negative binomial regression, modeled ethnicity, accounting clinical hospital characteristics socioeconomic status. Secondary outcomes included predictors LOS > 7 days (equivalent highest quartile), central venous catheter (CVC) placement, time debridement. Results We identified 2,388 patients discharged Median was 5 (IQR 3–7). Black (adjusted incidence rate ratio [aIRR] 1.15, 95%CI 1.05–1.27), Hispanic (aIRR 1.11, 95% CI 1.02–1.21), other 1.12, 1.01–1.23) were associated longer LOS, compared White (Figure 1). Additional factors prolonged Medicaid/self-pay status 1.14, 1.07–1.21) insurance 1.21, 1.02–1.45), private insurance; debridement procedure 1.31, 1.23–1.31); CVC placement 1.41, 1.31–1.51), complex chronic condition 1.11–1.33). The odds experiencing 46% higher (aOR 1.46, 1.01–2.11; Figure 2). There no on Model is adjusted location/teaching status, region, year, procedure, condition, weekend admission, discharge quarter, bed size, Zip code median income quartile. Conclusion Black, Hispanic, osteomyelitis experienced than children. Further research into mechanisms underlying these differences, including social determinants such as access care structural racism, may be important improve Disclosures All Authors: No reported disclosures.