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Chang L, Rees CA, Michelson KA. Association of Socioeconomic Characteristics With Where Children Receive Emergency Care. Pediatr Emerg Care. 2022;38(1):e264-e267doi: 10.1097/PEC.0000000000002244.
Chang, L., Rees, C. A., & Michelson, K. A. (2022). Association of Socioeconomic Characteristics With Where Children Receive Emergency Care. Pediatric emergency care, 38(1), e264-e267. https://doi.org/10.1097/PEC.0000000000002244
Chang, Lawrence, et al. "Association of Socioeconomic Characteristics With Where Children Receive Emergency Care." Pediatric emergency care vol. 38,1 (2022): e264-e267. doi: https://doi.org/10.1097/PEC.0000000000002244
Chang L, Rees CA, Michelson KA. Association of Socioeconomic Characteristics With Where Children Receive Emergency Care. Pediatr Emerg Care. 2022 Jan 01;38(1):e264-e267. doi: 10.1097/PEC.0000000000002244. PMID: 32947560; PMCID: PMC7960554.
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Pediatr Emerg Care. 2022 Jan 01;38(1):e264-e267. doi: 10.1097/PEC.0000000000002244.

Association of Socioeconomic Characteristics With Where Children Receive Emergency Care.

Pediatric emergency care

Lawrence Chang, Chris A Rees, Kenneth A Michelson

Affiliations

  1. Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.

PMID: 32947560 PMCID: PMC7960554 DOI: 10.1097/PEC.0000000000002244

Abstract

OBJECTIVE: Outcomes of emergency care delivered to children vary by patient-level socioeconomic factors and by emergency department (ED) characteristics, including pediatric volume. How these factors intersect in emergency care-seeking patterns among children is not well understood. The objective of this study was to characterize national associations of neighborhood income and insurance type of children with the characteristics of the EDs from which they receive care.

METHODS: We conducted a cross-sectional study of ED visits by children from 2014 to 2017 using the Nationwide Emergency Department Sample. We determined the associations of neighborhood income and patient insurance type with the proportions of visits to EDs by pediatric volume category, both unadjusted and adjusted for patient-level factors including urban-rural status of residence.

RESULTS: Of 107.6 million ED visits by children nationally from 2014 to 2017, children outside of the wealthiest neighborhood income quartile had lower proportions of visits to high-volume pediatric EDs (57.1% poorest quartile, 51.5% second, 56.6% third, 63.5% wealthiest) and greater proportions of visits to low-volume pediatric EDs (4.4% poorest, 6.4% second, 4.6% third, 2.3% wealthiest) than children in the wealthiest quartile. Adjustment for patient-level factors, particularly urban-rural status, inverted this association, revealing that lower neighborhood income was independently associated with visiting higher-volume pediatric EDs. Publicly insured children were modestly more likely to visit higher-volume pediatric EDs than privately insured and uninsured children in both unadjusted and adjusted analyses.

CONCLUSIONS: Nationally, children in lower-income neighborhoods tended to receive care in pediatric EDs with lower volume, an association that appears principally driven by urban-rural differences in access to emergency care.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

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