Evaluating the Impact of the Healthy Beginnings System of Care Model on Pediatric Emergency Department Utilization

Area of Science:

• Pediatric Health
• Healthcare Management
• Public Health

Background:

• The Healthy Beginnings System of Care (SOC) model aims to improve child health outcomes.
• Understanding the impact of SOC models on healthcare utilization, specifically emergency department (ED) visits, is crucial for optimizing pediatric care.
• Previous research has not fully elucidated the effect of SOC models on ED utilization rates in young children.

Purpose of the Study:

• To evaluate if enrollment in the Healthy Beginnings System of Care (SOC) model is associated with a decrease in emergency department (ED) visits.
• To analyze ED utilization trends before and after SOC model enrollment in children aged 6 months to 5.5 years.
• To investigate potential disparities in the effect of SOC enrollment on ED visits based on parental income levels.

Main Methods:

• A retrospective, longitudinal study design was employed, analyzing medical records from February 2011 to May 2013.
• The primary outcome measured was the rate of ED visits per quarter among children enrolled in the Healthy Beginnings SOC model.
• A multilevel, multivariate Poisson model was used to compare ED utilization rates before and after enrollment, controlling for sociodemographic factors.

Main Results:

• The impact of SOC enrollment on ED visit rates varied significantly by parental income.
• For children whose parents earned less than $5,000, $20,000-$29,999, or $30,000 or more annually, no significant difference in ED visit rates was observed post-enrollment.
• Conversely, children with parents earning $5,000-$19,999 annually experienced a significant increase in ED visits after enrolling in the SOC model (adjusted rate ratio, 1.48).

Conclusions:

• Enrollment in the Healthy Beginnings System of Care (SOC) model does not appear to reduce emergency department (ED) visits among enrolled children.
• Targeted interventions, including patient education on appropriate ED utilization, may be necessary to decrease ED visits in this population.
• Further research is needed to understand the mechanisms driving increased ED utilization in specific income groups within the SOC model.