Foster Care Status as an Understudied Social Driver of Health Outcomes for Children Needing Cardiac Surgery
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View abstract on PubMed
Summary
This summary is machine-generated.Children and youth in foster care (CYFC) with heart disease experience worse health outcomes and higher hospital use. Improving foster care status data is crucial for reducing health disparities in this vulnerable population.
Area Of Science
- Pediatric Cardiology
- Health Services Research
- Health Equity
Background
- Children and youth in foster care (CYFC) have elevated healthcare needs compared to their peers.
- Limited data exists on the cardiac health outcomes for CYFC.
- Understanding disparities in pediatric cardiac care is essential.
Purpose Of The Study
- To compare the cardiac surgery outcomes of CYFC with non-CYFC.
- To identify factors associated with adverse outcomes in CYFC undergoing cardiac surgery.
- To evaluate the accuracy of administrative data in identifying CYFC.
Main Methods
- Retrospective single-center study of pediatric patients (<18 years) undergoing cardiac surgery (2017-2022).
- CYFC identified via medical records and compared to non-CYFC on demographics, clinical factors, and outcomes.
- Generalized linear models used to assess associations with mortality, readmissions, and hospital days, adjusting for covariates.
- Analysis included Child Opportunity Index, payer, and race; ICD-10 code accuracy assessed using the Pediatric Health Information System.
Main Results
- Of 4431 patients, 67 (1.5%) were CYFC, exhibiting lower Child Opportunity Index scores and higher rates of Black race and Medicaid coverage.
- Adjusted analyses revealed CYFC had significantly higher mortality (aOR 2.7), readmissions (aIRR 1.24), and total hospital days (aECO 1.54).
- Foster care status capture in administrative data was poor (24% sensitivity).
Conclusions
- CYFC with heart disease face poorer long-term outcomes and increased healthcare utilization.
- Significant disparities exist, influenced by socioeconomic factors like Child Opportunity Index, payer status, and race.
- Enhanced administrative data collection for foster care status is imperative for targeted interventions and research to mitigate these disparities.
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