Lower Child Opportunity Index is associated with increased health care utilization following pediatric liver...

Area of Science:

• Pediatric Health
• Transplantation Medicine
• Health Disparities Research

Background:

• Social determinants of health (SDOH) significantly impact health outcomes, including acute care needs.
• Understanding SDOH's role in pediatric liver transplantation (LT) healthcare disparities is crucial.
• Mechanisms linking SDOH to adverse outcomes in pediatric LT patients remain unclear.

Purpose of the Study:

• To investigate the association between SDOH and healthcare utilization in children post-LT.
• To identify if SDOH influence acute care use and complication rates following pediatric LT.

Main Methods:

• Retrospective study merging data from the Organ Procurement and Transplantation Network (OPTN) and Pediatric Health Information System (PHIS) databases.
• Utilized the Child Opportunity Index (COI), a composite measure of SDOH, to stratify patients.
• Analyzed differences in hospital admission days and complication rates based on COI scores.

Main Results:

• Children with lower COI scores experienced 28% more hospital days in year 1 and 29% more in year 2 post-LT compared to those with higher COI.
• In the second year post-LT, 23% of children with lower COI were admitted with complications versus 18% with higher COI.
• Lower COI scores correlated with increased acute care utilization and complication-related admissions.

Conclusions:

• Child Opportunity Index (COI) scores effectively identify pediatric LT patients at higher risk for adverse health outcomes and increased acute care use.
• COI can serve as a valuable screening tool for clinical teams to allocate resources and mitigate acute care utilization post-LT.
• Targeting interventions based on SDOH, as measured by COI, may improve outcomes and reduce healthcare burdens in pediatric liver transplant recipients.