Using State Administrative Data to Identify Social Complexity Risk Factors for Children

Area of Science:

• Public Health
• Health Services Research
• Pediatric Health

Background:

• Screening for social determinants of health (SDOH) is crucial for improving child health outcomes but presents challenges.
• Identifying social complexity risk factors is essential for optimizing healthcare utilization in pediatric populations.

Purpose of the Study:

• To assess the feasibility of using integrated state administrative data to identify social complexity risk factors.
• To examine the relationship between identified social complexity risk factors and emergency department (ED) use in children.

Main Methods:

• Retrospective cohort study of 505,367 children with Washington State Medicaid coverage.
• Linked child and parent administrative data to identify social complexity risk factors (e.g., poverty, parent mental illness).
• Multivariate analyses were used to assess associations between risk factors and ED use rates.

Main Results:

• Nine of 11 identified social complexity risk factors were associated with increased ED use.
• A dose-response relationship was observed: higher numbers of risk factors correlated with higher ED visit rates.
• Children with 5 or more risk factors had approximately double the rate of ED use compared to those with none.

Conclusions:

• Integrated state administrative data effectively identify social complexity risk factors associated with higher ED use in Medicaid-insured children.
• State agencies can provide social risk scores to primary care to facilitate targeted screening and resource allocation.
• Proactive identification of social risk factors may prevent unnecessary ED visits and improve health outcomes for vulnerable children.