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Children in low opportunity neighborhoods had more emergency department (ED) visits, including low-resource intensity visits. Neighborhood context impacts child health and ED utilization patterns.

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Area of Science:

  • Pediatric Health
  • Public Health
  • Health Services Research

Background:

  • The Child Opportunity Index (COI) assesses neighborhood structural context influencing child development.
  • Understanding the link between neighborhood opportunity and healthcare access is crucial for public health.

Purpose of the Study:

  • To determine if the Child Opportunity Index (COI) is associated with emergency department (ED) utilization in children.
  • To analyze the relationship between neighborhood socioeconomic factors and pediatric ED use.

Main Methods:

  • Retrospective cohort study using the Pediatric Health Information Systems database (49 US children's hospitals).
  • Analysis of 6,810,864 ED visits by 3,999,880 children aged 0-17 years (2018-2019).
  • Generalized regression models adjusted for patient characteristics to assess associations between COI and ED visit outcomes (low-resource intensity, multiple visits, admission).

Main Results:

  • Children from very low COI neighborhoods had higher odds of low-resource intensity (LRI) ED visits (OR 1.35-2.40).
  • Higher ED utilization was observed in children from very low COI areas (≥2 visits OR 1.73, ≥3 visits OR 2.22).
  • Children from very low COI neighborhoods had a lower risk of hospital admission from the ED (OR 0.77).

Conclusions:

  • Low neighborhood opportunity is linked to increased overall ED utilization and more LRI visits among children.
  • These findings suggest opportunities for primary care interventions to reduce unnecessary ED use and costs.
  • Addressing neighborhood-level factors is key to optimizing child health outcomes and healthcare resource allocation.