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Age, Adverse Childhood Experiences, and Health Care Utilization.
Charles V Golden1, Raymen R Assaf1,2, Ricardo Aguilar1
1Children's Hospital of Orange County, Orange, California.
Pediatrics
|October 18, 2024
Summary
Adverse childhood experiences (ACEs) impact pediatric healthcare use differently by age. Infants with ACEs showed lower utilization, while older children had increased emergency department visits and hospitalizations.
Area of Science:
- Pediatric Health Services Research
- Childhood Trauma Studies
- Public Health Policy
Background:
- Adverse childhood experiences (ACEs) are linked to various health outcomes.
- Previous research has not fully elucidated age-dependent associations between ACEs and healthcare utilization.
Purpose of the Study:
- To determine if the relationship between ACEs and pediatric healthcare utilization varies by patient age.
- To identify age-specific patterns in healthcare access following ACEs screening.
Main Methods:
- Retrospective cohort study of 37,315 pediatric patients undergoing ACEs screening.
- ACEs scores categorized as none, low (1-3), or high (≥4).
- Multivariable logistic regression analyzed emergency department (ED) and inpatient utilization within 6 months post-screening.
Main Results:
- 15.7% of patients used ED services, and 2.5% were hospitalized within 6 months.
- Infants and toddlers with ACEs had lower odds of ED and inpatient use compared to those with no ACEs.
- Older children with ACEs demonstrated significantly higher odds of ED and inpatient utilization, increasing with age.
Conclusions:
- The association between ACEs and pediatric healthcare utilization is age-dependent.
- Findings suggest a more complex relationship than previously understood.
- Results can inform age-tailored therapeutic interventions for children exposed to ACEs.
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