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Disparities in Pediatric Emergency Department Revisits Within 7 Days by Disease Process
Sagar D Mehta1,2,3, Chris A Rees1,2,3, Swaminathan Kandaswamy1
1Department of Pediatrics, Emory University School of Medicine.
Pediatric Emergency Care
|April 21, 2025
Summary
Racial and ethnic disparities in emergency department (ED) revisits are significant, particularly for Hispanic and Black/African American children. Targeted interventions for specific diseases and upstream social determinants are crucial to reduce these ED revisit disparities.
Area of Science:
- Pediatric Emergency Medicine
- Health Disparities Research
- Public Health
Background:
- Emergency department (ED) revisits are a key indicator of healthcare quality and access.
- Disparities in healthcare access and outcomes persist across various patient demographics.
- Understanding disease-specific revisit patterns is essential for targeted quality improvement initiatives.
Purpose of the Study:
- To identify specific disease processes associated with the highest rates of emergency department (ED) revisit disparities.
- To analyze these disparities across race, ethnicity, language, insurance status, and Childhood Opportunity Index.
- To inform the development of targeted interventions to reduce healthcare inequities.
Main Methods:
- Retrospective, cross-sectional study of pediatric ED encounters (ages 0-18) discharged home.
- Analysis of over 1 million ED visits from 2018 to 2022 within a large pediatric health system.
- Multivariable logistic regression used to assess factors associated with 7-day ED revisits.
Main Results:
- Overall, 5.2% of pediatric ED encounters resulted in a revisit within 7 days.
- Black/African American, multiracial, and Hispanic patients, as well as those with public insurance, had significantly higher odds of ED revisits.
- Hispanic patient revisit disparities were concentrated in ENT/dental/mouth conditions, while Black/African American patient disparities were more widespread across diagnoses.
Conclusions:
- Disease-specific interventions are necessary to address ED revisit disparities.
- Addressing upstream social determinants of health is critical for reducing revisits in at-risk, minoritized populations.
- Reducing ED revisit disparities requires a multifaceted approach focusing on both clinical and social factors.
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