Do Unmet Health Needs Drive Pediatric Emergency Department Utilization?

Sojar, Sakina; Gjelsvik, Annie; Tsao, Hoi See; Amanullah, Siraj

doi:10.1097/pec.0000000000002319

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…Limited access to transportation among caregivers was associated with 18–51% of missed child medical appointments (unmet health care needs) and 68–87% of missed child prescriptions [ 52 , 53 ]. Results from a national survey that included 71,360 children, identified that children with two or more unmet health needs are at 2.3–6.1 times higher risk of visiting an emergency room than children without these needs [ 54 ]. Children’s unmet healthcare needs are commonly associated with poverty and insurance.…”

Section: Discussionmentioning

confidence: 99%

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Role of social determinants of health in differential respiratory exposure and health outcomes among children

et al. 2023

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Background Attributes defining the Social Determinants of Health (SDoH) are associated with disproportionate exposures to environmental hazards and differential health outcomes among communities. The dynamics between SDoH, disproportionate environmental exposures, and differential health outcomes are often specific to micro-geographic areas. Methods This study focused on children less than 20 years of age who lived in Douglas County, Nebraska, during 2016–2019. To assess the role of SDoH in differential exposures, we evaluated the association between SDoH metrics and criteria pollutant concentrations and the association between SDoH and pediatric asthma exacerbations to quantify the role of SDoH in differential pediatric asthma outcomes. The Bayesian Poisson regression model with spatial random effects was used to evaluate associations. Results We identified significant positive associations between the annual mean concentration of criteria pollutants (carbon monoxide, particulate matter2.5, nitrogen dioxide, sulfur dioxide) with race (Non-Hispanic Black and Hispanic/Latino), financial stability, and literacy. Additionally, there were significant positive associations between higher rates of pediatric asthma emergency department visits and neighborhoods with more Non-Hispanic Black children, children without health insurance coverage, and households without access to a vehicle. Conclusions Non-Hispanic Black and Hispanic/Latino children living in Douglas County, NE experience disproportionately higher exposure to criteria pollutant concentrations. Additionally, higher rates of asthma exacerbations among Non-Hispanic Black children could be due to reduced access to respiratory care that is potentially the result of financial instability and vehicle access. These results could inform city planners and health care providers to mitigate respiratory risks among these higher at-risk populations.

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Section: Discussionmentioning

confidence: 99%

“…Namely, Weitoft et al found significant associations between health insurance and female asthma exacerbation-related emergency visits [ 57 ]. Uninsured children with asthma are 1.4–2.4 times more likely to visit an emergency room than children with private insurance or a public health plan [ 54 , 58 ].…”

Section: Discussionmentioning

confidence: 99%