Distribution of Emergency Department Encounters and Subsequent Hospital Admissions for Children by Child Opportunity Index.
Objective: To evaluate differences in emergency department (ED) utilization and subsequent admission among children by Child Opportunity Index (COI). METHODS: We performed a cross-sectional study of pediatric (<18 years) encounters to 194 EDs in Illinois from 2016 to 2020. Each encounter was assigne...
| Publicado en: | Academic Pediatrics Vol. 22; no. 8; pp. 1468 - 1477 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Nov/Dec2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=160528340&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 160528340 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18762859 8NBK jtl: Academic Pediatrics issn: 18762859 maglogo: N pubinfo: dt: Nov/Dec2022 vid: 22 iid: 8 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 160528340 160528340 160528340 10.1016/j.acap.2022.06.003 160528340 ppf: 1468 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Distribution of Emergency Department Encounters and Subsequent Hospital Admissions for Children by Child Opportunity Index. aug: au: Ramgopal, Sriram Attridge, Megan Akande, Manzilat Goodman, Denise M. Heneghan, Julia A. Macy, Michelle L. affil: Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill sug: subj: Emergency Service Utilization Patient Admission In Infancy and Childhood Health Resource Utilization Human Male Female Child Cross Sectional Studies Adolescence Infant Infant, Newborn Illinois Healthcare Disparities Health Status Disparities Emergency Care Poverty Scales Child: 6-12 years Adolescent: 13-18 years Infant: 1-23 months Infant, Newborn: birth-1 month Male Female ab: Objective: To evaluate differences in emergency department (ED) utilization and subsequent admission among children by Child Opportunity Index (COI). METHODS: We performed a cross-sectional study of pediatric (<18 years) encounters to 194 EDs in Illinois from 2016 to 2020. Each encounter was assigned to quntiles of COI 2.0 by postal code. We described the difference in the percent of encounters between lower (Very Low and Low) and higher (Very High and High) COI overall and among diagnoses with overrepresentation from lower COI groups. We evaluated the association of diagnosis with COI in ordinal models adjusted for demographics. Results: There were 4,653,026 eligible ED encounters classified by COI as Very Low (28.6%), Low (24.8%), Moderate (20.3%), High (15.6%), and Very High (10.8%) (difference between low and high COI encounters 27.0%). Diagnoses with the greatest difference between low and high COI were eye infection, upper respiratory tract infections, and cough. The COI distribution for children admitted from the ED (n = 140,298) was 29.1% Very Low, 19.3% Low, 18.2% Moderate, 17.7% High, and 15.7% Very High (percent difference 15.1%). Diagnoses with the greatest differences between low and high COI among admitted patients were sickle cell crisis, asthma, and influenza. All ED diagnoses and 7/12 admission diagnoses were associated with lower COI in multivariable ordinal models. CONCLUSIONS: Children from lower COI areas are overrepresented in ED and inpatient encounters overall and within certain diagnosis groups. Further research is required to examine how health outcomes may be influenced by the structural and contextual characteristics of a child's neighborhood. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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