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Characteristics of Children Enrolled in Medicaid With High-Frequency Emergency Department Use

Alon Peltz1,2, Margaret E Samuels-Kalow3, Jonathan Rodean4

  • 1Robert Wood Johnson Foundation Clinical Scholars Program and alon.peltz@yale.edu.

Pediatrics
|August 3, 2017
PubMed

Insights

One in six children with high emergency department (ED) use in a year continue to use ED services frequently over the next two years. Adolescents and children with multiple chronic conditions are most likely to sustain high ED use.

Area of Science:

  • Pediatric Health
  • Healthcare Utilization
  • Public Health

Background:

  • High-frequency emergency department (ED) use is a concern in pediatric populations.
  • Understanding patterns of sustained ED use is crucial for resource allocation and intervention development.

Purpose of the Study:

  • To characterize Medicaid-insured children with high ED utilization in one year who sustain this high use over the subsequent two years.

Main Methods:

  • Retrospective longitudinal cohort study of 470,449 Medicaid-insured children (aged 1-16) from the MarketScan Medicaid database (2012-2014).
  • Identified children with high ED use (≥4 visits in 2012) and analyzed characteristics associated with sustained high use (≥8 visits in 2013-2014).
  • Generalized linear model used to determine patient characteristics linked to sustained high ED use.

Main Results:

  • 8.5% of children had high ED use in 2012, accounting for 25% of total ED visits.
  • 16% of high-use children sustained high ED utilization over the following two years.
  • Adolescents (aOR 1.4), disabled children (aOR 1.3), and those with ≥3 chronic conditions (aOR 2.1) showed the highest likelihood of sustained high ED use.

Conclusions:

  • Sustained high ED use affects a significant proportion of children initially identified with frequent ED visits.
  • Adolescent status and multiple chronic conditions are key predictors of persistent high ED utilization.
  • Targeted interventions are recommended for high-risk pediatric populations to reduce reliance on emergency departments.
Abstract

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