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Published on: June 11, 2012
Material community deprivation and hospital utilization during the first year of life: an urban population-based
Cole Brokamp1, Andrew F Beck2, Neera K Goyal3
1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Insights
Community material deprivation significantly increases infant hospital utilization. Addressing income inequalities can reduce healthcare needs in the first year of life.
Area of Science:
- Public Health
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Infant hospital utilization is a significant healthcare cost.
- Understanding the impact of socioeconomic factors on child health is crucial.
- Community-level factors may influence individual healthcare needs.
Purpose of the Study:
- To analyze individual hospital use in infants.
- To test if community material deprivation increases healthcare utilization.
- To quantify the relationship between deprivation and infant hospitalizations.
Main Methods:
- Utilized a population-based perinatal data repository.
- Linked electronic health records to hospital utilization data.
- Employed zero-inflated Poisson and Cox proportional hazards regression models.
Main Results:
- A 10% increase in deprivation index correlated with increased length of stay.
- Higher deprivation linked to more hospital encounters.
- Increased hazard for hospitalization utilization observed with higher deprivation.
Conclusions:
- Material deprivation is a significant driver of infant hospital use.
- Interventions targeting material deprivation and income inequality are recommended.
- Reducing socioeconomic disparities can lower infant healthcare utilization.
Purpose:
The purpose of the study was to conduct an individual-level analysis of hospital utilization during the first year of life to test the hypothesis that community material deprivation increases health care utilization.
Methods:
We used a population-based perinatal data repository based on linkage of electronic health records from regional delivery hospitals to subsequent hospital utilization at the region's only dedicated children's hospital. Zero-inflated Poisson and Cox proportional hazards regression models were used to quantify the causal role of a census tract-based deprivation index on the total number, length, and time until hospital utilization during the first year of life.
Results:
After adjusting for any neonatal intensive care unit admission, chronic complex conditions, race and ethnicity, insurance status, birth season, and very low birth weight, we found that a 10% increase in the deprivation index caused a 1.032-fold increase (95% confidence interval (CI), [1.025-1.040]) in post initial hospitalization length of stay, a 1.011-fold increase (95% CI, [1.002-1.021]) in number of post initial hospital encounters, and 1.022-fold increase (95% CI, [1.009-1.035]) in hazard for hospitalization utilization during the first year of life.
Conclusions:
Interventions designed to reduce material deprivation and income inequalities could significantly reduce infant hospital utilization.
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