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Social Risk Factors Influence Pediatric Emergency Department Utilization and Hospitalizations

Joseph Rigdon1, Kimberly Montez2, Deepak Palakshappa3

  • 1Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC.

The Journal of Pediatrics
|June 13, 2022
PubMed

Insights

Children’s social risk factors are linked to more emergency department (ED) visits and hospitalizations. However, these factors did not significantly affect the timing of a child’s first subsequent ED visit or hospitalization.

Area of Science:

  • Pediatric Health
  • Social Determinants of Health
  • Healthcare Utilization

Background:

  • Social risk factors significantly impact child health outcomes and healthcare access.
  • Understanding the relationship between social risks and healthcare utilization is crucial for targeted interventions.
  • Previous studies highlight the need to screen for social determinants of health in pediatric populations.

Purpose of the Study:

  • To investigate the association between children's social risk factors and emergency department (ED) visits or hospitalizations.
  • To determine if social risk factors influence the time to a child's first subsequent ED visit or hospitalization.
  • To quantify the impact of the number and type of social risk factors on healthcare utilization.

Main Methods:

  • Retrospective cohort study of 4674 pediatric patients from 2017-2021.
  • Utilized negative binomial or Poisson regression to model ED and hospitalization rates based on social risk factors.
  • Employed time-varying Cox models to assess the time to first subsequent ED visit or hospitalization, controlling for covariates.

Main Results:

  • Children with social risk factors had higher rates of ADHD, failure to gain weight, asthma, and prematurity.
  • Increased social risk factors were associated with higher rates of ED utilization (IRR, 1.18) and hospitalizations (IRR, 1.36).
  • No significant association was found between social risk factors and the time to first ED visit (HR, 0.95) or hospitalization (HR, 1.15).

Conclusions:

  • Social risk factors are associated with increased overall ED utilization and hospitalizations in children.
  • The presence of social risk factors did not significantly alter the time to subsequent acute care use.
  • Further research should focus on interventions addressing specific social risks like food insecurity and transportation to reduce healthcare utilization.
Abstract

Keywords:
food insecurityhealth care utilizationhealth disparitiespediatricsocial determinants of healthsocial risk factors

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