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Published on: February 12, 2015
Child tobacco smoke exposure and healthcare resource utilization patterns
Ashley L Merianos1, Roman A Jandarov2, Judith S Gordon3
1School of Human Services, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA. ashley.merianos@uc.edu.
Insights
Children exposed to tobacco smoke (TSE) face higher healthcare resource utilization. Early screening and interventions for TSE are crucial to reduce these patterns.
Area of Science:
- Pediatric healthcare utilization
- Environmental health impacts on children
- Tobacco smoke exposure effects
Background:
- Tobacco smoke exposure (TSE) is a significant environmental factor affecting children's health.
- Limited data exists on the association between TSE and healthcare resource utilization in pediatric emergency departments.
- Understanding these patterns is vital for targeted interventions and resource allocation.
Purpose of the Study:
- To investigate the relationship between healthcare resource utilization in children exposed to tobacco smoke (TSE group) versus unexposed children (non-TSE group).
- To identify specific healthcare services and interventions more frequently utilized by TSE children.
- To provide evidence supporting the need for TSE screening and prevention programs.
Main Methods:
- Matched cohort study comparing 380 TSE children with 1140 non-TSE children using propensity scores.
- Healthcare resource utilization variables included procedures, diagnostic tests, disposition, and medications.
- Logistic and linear regression models were employed to analyze the data.
Main Results:
- TSE children showed increased utilization of nasal bulb suctioning, infectious diagnostic tests, laboratory tests, and radiologic tests.
- The TSE group had higher rates of hospital admission and received more steroids and intravenous fluids during visits.
- Asthmatic children in the TSE group received more complex medication regimens and prescriptions.
Conclusions:
- Children exposed to tobacco smoke exhibit significantly higher healthcare resource utilization patterns.
- Findings underscore the importance of routine screening for tobacco smoke exposure in pediatric care.
- Implementing TSE prevention and remediation interventions is critical to mitigate increased healthcare demands.
Background:
The objective was to examine the relationship between healthcare resource utilization patterns in tobacco smoke-exposed children (TSE group) compared with unexposed children (non-TSE group).
Methods:
We matched 380 children in the TSE group with 1140 children in the non-TSE group based on child age, sex, race, and ethnicity using propensity scores. Healthcare resource utilization variables included respiratory-related procedures, diagnostic testing, disposition, and medications. Logistic and linear regression models were built.
Results:
Child mean age was 4.9 (SD = 0.1) years, 50.5% were female, 55.5% black, and 73.2% had public insurance/self-pay. Compared to the non-TSE group, the TSE group was at increased odds to have the following performed/obtained: nasal bulb suctioning, infectious diagnostic tests, laboratory tests, and radiologic tests. The TSE group was more likely to be admitted to the hospital, and more likely to receive steroids and intravenous fluids during their visit. Among asthmatics, the TSE group was more likely to receive steroids, albuterol, or ipratropium alone, or a combination of all three medications during their visit, and be prescribed albuterol alone or steroids and albuterol.
Conclusion:
Tobacco smoke-exposed children are more likely to have higher resource utilization patterns, highlighting the importance of screening and providing TSE prevention and remediation interventions.
Impact:
Tobacco smoke exposure may affect the healthcare resource utilization patterns of children. Evidence is lacking concerning these associations among the highly vulnerable pediatric emergency department patient population. This study examined the association between tobacco smoke exposure and healthcare resource utilization patterns among pediatric emergency department patients. Tobacco smoke exposure increased the risk of pediatric patients having respiratory-related procedures, respiratory-related and non-respiratory-related testing, medications administered during the pediatric emergency department visit, and medications prescribed for home administration. Tobacco smoke-exposed patients were more likely to be admitted to the hospital compared to unexposed patients.
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