Association of Income Inequality With Pediatric Hospitalizations for Ambulatory Care–Sensitive Conditions

Bettenhausen, Jessica L.; Colvin, Jeffrey D.; Berry, Jay G.; Puls, Henry T.; Markham, Jessica L.; Plencner, Laura; Krager, Molly; Johnson, Matthew; Queen, Mary Ann; Walker, Jacqueline M.; Latta, Grant M.; Riss, Robert; Hall, Matt

doi:10.1001/jamapediatrics.2017.0322

Cited by 29 publications

(28 citation statements)

References 30 publications

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“…The pneumonia hospitalisation rate was 2.57 times greater in the most compared to the least materially deprived groups. Our findings are consistent with previous research showing socio‐economic differences in ambulatory care and hospitalisations for respiratory diseases in the general population and among children …”

Section: Commentsupporting

confidence: 93%

“…Our findings are consistent with previous research showing socio-economic differences in ambulatory care and hospitalisations for respiratory diseases in the general population 7,40 and among children. 41,42 A number of factors may have influenced the material deprivation gradients we identified. Material deprivation has been associated with increased exposures to risk factors for respiratory diseases, such as unhealthy housing conditions, passive tobacco smoking, outdoor pollution, malnutrition, and limited breast feeding.…”

Section: Discussionmentioning

confidence: 99%

“…44 Collaborations across the health sector and other government departments on policies and programmes targeting fundamental causes of material and social deprivation may more effectively address the health inequalities in the use of ED and hospital services for paediatric respiratory problems. 42,43 Further research on the underlying mechanisms of respiratory diseases may contribute to minimise the burden on ED and hospital care delivery. 13 Given that inequalities in ED visits and hospitalisations might not reflect inequalities in availability, access, and quality of primary health care, 44 research combining analysis of primary, secondary, and tertiary care is needed to better understand the trajectories of health-seeking practices.…”

Section: Discussionmentioning

confidence: 99%

“…Collaborations across the health sector and other government departments on policies and programmes targeting fundamental causes of material and social deprivation may more effectively address the health inequalities in the use of ED and hospital services for paediatric respiratory problems . Further research on the underlying mechanisms of respiratory diseases may contribute to minimise the burden on ED and hospital care delivery .…”

Section: Commentmentioning

confidence: 99%

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Health gradients in emergency visits and hospitalisations for paediatric respiratory diseases: A population‐based retrospective cohort study

Belon

Serrano-Lomelin

Nykiforuk

et al. 2020

Paediatric Perinatal Epid

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Background Socio‐economically deprived children face a disproportionate burden of respiratory diseases. The association between area‐level material and social deprivation and emergency department (ED) visits and hospitalisations for paediatric respiratory diseases has not been explored. Objectives We evaluated health inequalities in emergency department (ED) visits and hospitalisations for paediatric respiratory diseases according to material and social deprivation indexes. Methods This population‐based retrospective cohort study deterministically linked birth, ED visits and hospitalisation data, and census‐based, area‐level deprivation indexes for all singleton children born in the province of Alberta, Canada, between 2005 and 2010 who had at least one recorded ED visit or hospitalisation for respiratory diseases in their first five years of life. We classified ED visits and hospitalisations for seven respiratory diseases by deprivation indexes. Concentration indexes (CInd) and area‐level concentration curves measured health gradients across deprivation groups. Rate ratios (RR) evaluated associations between deprivation indexes and respiratory episodes of care. Results The study cohort included 198 572 newborns. The highest CInd were found in ED visits for other acute lower respiratory tract infections (oLRTI; CInd −0.22, 95% confidence interval [CI] −0.32, −0.12) and bronchiolitis (CInd −0.21, 95% CI −0.29, −0.12), and for pneumonia hospitalisations (CInd −0.23, 95% CI −0.33, −0.13). Croup ED visits had a low inequality degree. Compared to social deprivation, the material deprivation index presented a more consistent health gradient of increased episodes of care with increasing deprivation. oLRTI ED visits (RR 2.60, 95% CI 2.34, 2.92) and pneumonia hospitalisations (RR 2.57, 95% CI 2.31, 2.86) presented the largest inequalities between the least and most materially deprived groups. Conclusions We found a concentration of ED visits and hospitalisations for paediatric respiratory diseases in the most deprived groups. However, health inequalities are present across the material and social deprivation spectrum. Compared to the social deprivation index, the material index presented clearer paediatric respiratory health gradients.

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Section: Commentsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

See 2 more Smart Citations

Health gradients in emergency visits and hospitalisations for paediatric respiratory diseases: A population‐based retrospective cohort study

Belon

Serrano-Lomelin

Nykiforuk

et al. 2020

Paediatric Perinatal Epid

View full text Add to dashboard Cite

show abstract

“…Diversos estudos nos contextos nacional e internacional indicam as desigualdades socioeconômicas, especialmente a renda, associadas à ICSAP, e revelam que a melhoria desses indicadores tem potencial para a redução da hospitalização em crianças BETTENHAUSEN et al, 2017;ROOS;DRAGAN;SCHROTH, 2017;WEEKS;VENTELOU;PARAPONARIS, 2016…”

Section: Atributos Derivadosunclassified

Internações hospitalares de crianças por condições sensíveis à Atenção Primária em região de fronteira

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A Deus, pela grandeza de sua presença em minha vida. À minha querida orientadora, Profª Drª Maria Cândida Carvalho Furtado, carinhosamente "Can", por aceitar este desafio junto comigo, pela confiança depositada durante todos estes anos, pelos seus ensinamentos, conselhos, companhia, sobretudo pela sua amizade, carinho e paciência. Serei eternamente grata por tudo.Ao meu esposo, Jerri, por todo o apoio, incentivo e companheirismo durante esta trajetória e por suportar minha ausência e se dedicar ao cuidado do nosso filho.Ao Gabriel, meu filho amado, que pacientemente me esperou, durante todos os días em que estive longe, e sempre me recebia com seu melhor sorriso, enchendo-me de forças para nunca desistir.A minha amiga de longa data, e também do doutorado, Luciana Fabriz, que compartilhou comigo esta jornada, desde o preparo para o processo seletivo até o desfecho deste trabalho.As minhas amigas do doutorado, Eliana, Luciana, Rosane e Andrea, obrigada pelo apoio, pela parceria, pelos momentos de desabafo e pela companhia durante as longas viagens até Ribeirão Preto.

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Ambulatory Care Sensitive Admissions in Individuals With Autism Spectrum Disorder, Intellectual Disability, and Population Controls

et al. 2018

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Ambulatory care sensitive (ACS) admissions are those for which effective primary care can prevent the need for emergency department (ED) visits and inpatient hospitalizations, and are an indicator of primary care access. Individuals with autism spectrum disorder (ASD) and/or intellectual disability (ID) may be at higher risk for ACS admissions than individuals in the general population due to difficulty accessing primary care. The objective of this study was to compare the incidence of ACS admissions among four cohorts of individuals aged 2–24 years: ASD without co‐occurring ID (ASD‐only), ASD with co‐occurring ID (ASD + ID), ID without ASD (ID‐only), and population controls (PC). Data from ED visits and inpatient hospitalizations occurring between January 1, 2000 and December 31, 2015 were examined to identify ACS admissions. Generalized linear models were used to examine differences between cohorts on the number of ACS ED visits and inpatient hospitalizations. Results revealed the ASD + ID and ID‐only cohorts had significantly higher rates of ACS inpatient hospitalizations than the PC cohort. Additionally, the ID‐only cohort had higher rates of ACS ED visits than the PC cohort. The ASD‐only and PC cohorts did not differ on incidence of ACS admissions. These findings suggest that presence of an ID with or without co‐occurring ASD increased the risk for ACS inpatient hospitalizations, and presence of ID‐only increased the risk for ACS ED visits. Future work should examine trajectories of ACS admissions over time and consider inclusion of additional characteristics that may elucidate reasons for differences in ACS admissions among these groups. Autism Res 2019, 12: 295–302 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Preventable hospitalizations are a common indicator of problems with access to quality primary healthcare. Findings of this study suggest that individuals with intellectual disability, with or without autism spectrum disorder, have higher rates of preventable hospitalizations than the general population. Further research is needed to understand how to improve access to primary care and reduce preventable hospitalizations for this vulnerable population.

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Association of Income Inequality With Pediatric Hospitalizations for Ambulatory Care–Sensitive Conditions

Cited by 29 publications

References 30 publications

Health gradients in emergency visits and hospitalisations for paediatric respiratory diseases: A population‐based retrospective cohort study

Health gradients in emergency visits and hospitalisations for paediatric respiratory diseases: A population‐based retrospective cohort study

Internações hospitalares de crianças por condições sensíveis à Atenção Primária em região de fronteira

Ambulatory Care Sensitive Admissions in Individuals With Autism Spectrum Disorder, Intellectual Disability, and Population Controls

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