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Impact of Chronic Conditions on Emergency Department Visits of Children Using Medicaid

Jay G Berry1, Jonathan Rodean2, Matthew Hall2

  • 1Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.

The Journal of Pediatrics
|December 17, 2016
PubMed

Insights

Children with multiple chronic conditions and medical technology needs visit the emergency department (ED) more frequently. Specific conditions like sickle cell anemia, epilepsy, and asthma are linked to higher ED use, highlighting areas for intervention.

Area of Science:

  • Pediatric Health Outcomes
  • Healthcare Services Research
  • Chronic Disease Management

Background:

  • Emergency department (ED) utilization is a significant concern in pediatric healthcare.
  • Understanding the factors driving ED visits, particularly among children with chronic conditions, is crucial for resource allocation and care planning.

Purpose of the Study:

  • To evaluate the association between chronic conditions and emergency department (ED) utilization in children.
  • To identify specific chronic conditions and medical technology needs that contribute to higher ED visit rates.

Main Methods:

  • Retrospective analysis of over 1.8 million ED visits for over 3.2 million children enrolled in Medicaid from 10 states in 2010.
  • Utilized the Agency for Healthcare Research and Quality's Chronic Condition Indicator system to categorize chronic conditions.
  • Employed Poisson regression to compare ED visit rates based on the number and type of chronic conditions and medical technology use.

Main Results:

  • The overall annual ED visit rate was 569 per 1000 enrollees.
  • ED visit rates increased by 180% as the number of chronic conditions rose from zero to three or more.
  • Children requiring medical technology had 174% higher ED visit rates compared to those without.

Conclusions:

  • Children with multiple chronic conditions, those requiring medical technology, and specific conditions like sickle cell anemia, epilepsy, and asthma exhibit the highest rates of emergency department visits.
  • Further research is needed to explore the preventability of these ED visits and identify strategies for reducing healthcare utilization in this population.
Abstract

Keywords:
Medicaidchronic conditionsemergency department

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