Understanding Variation In Nonurgent Pediatric Emergency Department Use In Communities With Concentrated Disadvantage

Area of Science:

• Public Health
• Health Services Research
• Sociology

Background:

• Children in socioeconomically disadvantaged communities exhibit higher rates of nonurgent emergency department (ED) visits.
• Understanding the factors influencing these utilization patterns is crucial for developing targeted interventions.

Purpose of the Study:

• To investigate sociodemographic and structural factors differentiating low-utilization from high-utilization nonurgent pediatric ED visits in disadvantaged areas.
• To identify key community-level characteristics associated with reduced nonurgent ED use among children.

Main Methods:

• A spatial regression model was applied to 264 census block groups in Pittsburgh, Pennsylvania.
• Block groups were categorized based on observed versus expected rates of nonurgent pediatric ED visits.

Main Results:

• Low-utilization block groups showed higher percentages of households with two adults, high school graduates, vehicle access, sound housing, and owner-occupancy compared to high-utilization groups.
• No significant differences were found in proximity to public transit or primary care, or in children's health insurance coverage rates between low- and high-utilization groups.

Conclusions:

• Community-level factors such as household structure, education, housing quality, and vehicle access are associated with nonurgent pediatric ED utilization in disadvantaged areas.
• Interventions to reduce nonurgent ED visits should address financial, time, transportation, and health literacy barriers to primary care access.