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Hospital and emergency department use by young low-income children
B J Polivka1, J T Nickel, P J Salsberry
1The Ohio State University, College of Nursing, Columbus 43210, USA.
Insights
Maternal health care use and child’s age and chronic conditions predict child hospitalization. Maternal emergency department (ED) use, Medicaid plan, and rural residence predict child ED visits in low-income families.
Area of Science:
- Health Services Research
- Pediatric Health
- Health Equity
Background:
- Limited data exist on factors influencing healthcare service utilization among low-income young children.
- Understanding these determinants is crucial for improving access and outcomes for this vulnerable population.
Purpose of the Study:
- To identify predictors of hospitalization and emergency department (ED) use in young children from low-income families.
- To apply the Aday and Andersen Access Framework to analyze healthcare access and utilization patterns.
Main Methods:
- A structured face-to-face interview was conducted with 474 low-income mothers of children under six years old in central Ohio.
- Data collected included sociodemographic status, health status, healthcare service use, and access to care for both mother and child.
- Low-income status was defined by Medicaid eligibility or lack of insurance for the mother or child.
Main Results:
- Fifteen percent of children were hospitalized, and 50% visited an ED in the past year.
- Child hospitalization was linked to maternal hospitalization, younger child age (under 1 year), and multiple chronic conditions (≥2).
- Child ED use was associated with maternal ED use, Medicaid fee-for-service plans, and rural residence.
Conclusions:
- Maternal healthcare utilization (hospitalization/ED visits) emerged as a significant predictor for both child hospitalization and ED use.
- Enabling factors like Medicaid plans and rurality influenced ED use, while child health needs primarily predicted hospitalization.
- Further research is recommended to explore the maternal-child healthcare use linkage and the impact of healthcare innovations on service utilization in this demographic.
Background:
Limited data are available concerning determinants of health care service usage by low-income young children.
Objectives:
To explore predictors of hospitalization and emergency department (ED) use by young children of low-income families by using the Aday and Andersen Access Framework.
Methods:
Low-income women (n = 474) with a child younger than 6 years completed a structured face-to-face interview at human service offices or Women, Infants, and Children (WIC) clinics in four central Ohio counties. Women were considered low-income if they or their child were Medicaid eligible or uninsured. Data were collected for both the mother and the index child on sociodemographic status, health services use, health status, and access to care.
Results:
Fifteen percent of the children had been hospitalized the previous year, and half had an ED visit. Hospitalization was significantly related to maternal hospitalization the previous year (OR = 2.5), child age younger than 1 year old (OR = 2.1) and more than two chronic conditions (OR = 2.2). Maternal ED usage in the last year (OR = 2.2), Medicaid fee for service plan (OR = 1.7), and rural residence (OR = 2.0) were predictive of ED use.
Conclusions:
Predisposing characteristics (maternal hospital/ED use) were predictive of both hospitalization and ED use by the index child. Enabling characteristics (fee-for-service Medicaid plan, rurality) were only predictive of ED use, and need characteristics (child's health) were only predictive of hospitalization. Further research to explore linkages between maternal and child use of health care services as well as the effect of changes in health care access, managed care, and other innovations on hospitalization and ED use in young, low-income children is recommended.
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