Differences in healthcare resource utilization by race/ethnicity among moderate to late preterm infants with respiratory distress Syndrome, Northern California

Racial and ethnic disparities in healthcare resource utilization (HCRU) are well-documented among extremely and very preterm infants but remain understudied among more mature preterm populations. This study evaluated HCRU by race/ethnicity among moderate (32-33 weeks) and late preterm infants (34-36 weeks) with respiratory distress syndrome (RDS; defined as ICD-10-CM P22.0) at Kaiser Permanente Northern California (2019-2023). Infants (n = 1674) with RDS requiring >12 h of respiratory support were included. HCRU was evaluated during birth hospitalization [respiratory support, length of stay (LOS)] and one-year post-discharge [emergency department (ED) visits, hospitalization]. No racial or ethnic differences were observed during hospitalization. Post-discharge, Black and Hispanic infants had higher risk of respiratory/infectious ED visits (Black, aOR=1.72 [95% CI = 1.05-2.81]; Hispanic, aOR=2.18 [95% CI = 1.56-3.06]; reference=White). Hispanic infants also had higher risks of respiratory/infectious hospitalizations (aOR=2.53 [95% CI = 1.11-5.78]). While inpatient HCRU was similar across race/ethnicity, disparities emerged one-year post discharge, particularly in Black and Hispanic infants.