title: Ethnic and gender inequities in the evaluation of referred short children.
abstract: OBJECTIVE
  To examine ethnicity and gender differences in the evaluation of referred children with short stature and to investigate adherence of the primary care evaluation to published guidelines.
  
  
  METHODS
  Cross-sectional study in a referral center. 371 short patients aged 2-18 years were included. Outcome measures were patient's growth characteristics, final diagnosis, and prevalence of pre-referral patient data.
  
  
  RESULTS
  The study population was composed of 239 Bedouin children and 132 Jewish children (p < 0.0001). More males (61%) than females were evaluated (p < 0.0001). There were no significant differences between males and females in age and growth parameters at the time of referral. Bedouins, males and females, were significantly shorter than their Jewish counterparts at the time of referral: height SD -2.44 ± 0.73 and -2.62 ± 1.05 versus -2.13 ± 0.55 and -2.21 ± 0.57, respectively (p < 0.05). There were no significant ethnic or gender differences in the final diagnosis. Significant deficiencies in the primary care evaluation of referred short children were found.
  
  
  CONCLUSIONS
  We demonstrated novel ethnic- and gender-based inequities in the evaluation of referred short children. We found that the current evaluation of short stature in our area does not comply with existing guidelines.
authors.affiliation: Faculty of Health Sciences, Joyce and Irving Goldman Medical School, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Yardeni
authors.forename: Neta
authors.initials: N
authors.lastname: Loewenthal
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Limony
authors.forename: Eli
authors.initials: E
authors.lastname: Hershkovitz
mesh_terms: D000293:Adolescent; D018912:Arabs; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D006130:Growth Disorders / Q000175:diagnosis* / Q000208:ethnology*; D019983:Guideline Adherence; D006297:Health Services Accessibility; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007585:Jews; D008297:Male; D011320:Primary Health Care / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards*; D012737:Sex Factors; D012959:Socioeconomic Factors