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Use of health care by chronically ill children in rural Florida
Insights
Healthcare utilization for chronically ill, rural, low-income children was studied. Activity limitations, younger age, and white race were linked to higher healthcare use, but much variation remains unexplained.
Area of Science:
- Pediatric Healthcare Research
- Rural Health Disparities
- Chronic Illness Management
Background:
- Ambulatory care and hospital use are significant for chronically ill children.
- Understanding factors influencing healthcare resource utilization is crucial for this population.
- Rural, low-income children with chronic conditions represent a vulnerable group with potentially unique healthcare needs.
Purpose of the Study:
- To investigate factors influencing ambulatory care and hospital use in chronically ill, rural, low-income children.
- To compare healthcare utilization rates in this population to national data.
- To identify predictors of high healthcare resource consumption.
Main Methods:
- A stratified random sample of 672 Medicaid-eligible children under 17 years old in northern Florida was analyzed.
- Data on ambulatory care visits and hospital use were collected.
- Statistical analyses examined associations between healthcare use and factors like activity limitations, age, race, and primary diagnoses.
Main Results:
- Healthcare utilization rates were similar to national studies of chronically ill children.
- Increased limitations in activity significantly correlated with higher healthcare use.
- Younger children and white children exhibited significantly higher use rates compared to older children and black children.
- Despite identified associations, a substantial portion of healthcare resource variation remained unexplained.
Conclusions:
- Activity limitations, younger age, and white race are associated with increased healthcare utilization in chronically ill, rural, low-income children.
- Current models do not fully explain the variation in healthcare resource consumption within this population.
- Identifying high-cost users remains a challenge, necessitating further research into underlying determinants of healthcare use.
Abstract:
Factors that influence ambulatory care (visits to physicians and emergency rooms) and use of hospitals were investigated in a population of chronically ill, rural, low-income children. Rates of use for this population--a stratified random sample of 672 Medicaid-eligible children under age 17 years who lived in a 24-county area of northern Florida--were similar to those in a national study of chronically ill children. Further, the rates were shown to increase significantly as limitations to activity increased. Younger children and white children were also shown to have significantly higher use rates than older children and black children. Despite these associations, and those related to primary diagnoses, none of the analyses were able to explain much of the variation in the use of health care resources. The findings were similar to those of other studies; thus, the identification of the relatively small numbers of children who consume relatively large amounts of health care remains elusive.
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