Influence of Socioeconomic Context on the Rehospitalization Rates of Infants Born Preterm

Laugier, Olivia; Garcia, Patricia; Daguzan, Alexandre; Tardieu, Sophie; Sambuc, Roland; Boubred, Farid

doi:10.1016/j.jpeds.2017.08.001

Cited by 34 publications

(39 citation statements)

References 26 publications

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“…16 Another group studied hospital admission of preterm infants ≤32 weeks and 6 days of gestation who received follow-up in a French regional medical network with a high level of health care. 10 Similar to our study, they used a neighbourhood-based social deprivation index and found that infants living in the most deprived areas were 2.2 times more likely (95% CI 1.5, 3.6) to be hospitalised for any cause during the first…”

Section: Discussionsupporting

confidence: 78%

“…However, the relationship between neighbourhood characteristics and health outcomes appears to be independent of the socioeconomic position of individual persons, suggesting that attributes of neighbourhoods themselves may be important to infant health outcomes . Another group studied hospital admission of preterm infants ≤32 weeks and 6 days of gestation who received follow‐up in a French regional medical network with a high level of health care . Similar to our study, they used a neighbourhood‐based social deprivation index and found that infants living in the most deprived areas were 2.2 times more likely (95% CI 1.5, 3.6) to be hospitalised for any cause during the first year of life compared to infants in the least deprived areas …”

Section: Commentmentioning

confidence: 51%

“…year of life compared to infants in the least deprived areas. 10 We found that census tract level educational attainment, housing-burdened low-income households, linguistic isolation, poverty and unemployment were each strongly associated with hospital admission for respiratory causes in the univariate analysis, and poverty TA B L E 4 Adjusted relative risk and 95% confidence interval for respiratory admission or death following respiratory admission in preterm infants (<37 wk) by sociodemographic deprivation score and air quality exposure score and educational attainment remained a risk factor in the multivariable model. Our results have shown some collinearity between our SES variable as a probable explanation for these negative results in the multivariable model.…”

Section: Discussionmentioning

confidence: 81%

“…[6][7][8][9] However, the association between air quality and hospital admissions related to respiratory illness has not been investigated in preterm infants. With regard to socioeconomic status, a study performed in a French regional medical network showed that hospitalisation after very preterm birth was higher for children living in neighbourhoods with a high socioeconomic deprivation index, 10 but it remains unknown if these finding extend to less preterm infants and different health care regions.…”

Section: Backg Rou N Dmentioning

confidence: 99%

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Cohort study of respiratory hospital admissions, air quality and sociodemographic factors in preterm infants born in California

Steurer

Costello

Baer

et al. 2020

Paediatric Perinatal Epid

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Background Preterm infants suffer from respiratory morbidity especially during the first year of life. Objective To investigate the association of air quality and sociodemographic indicators on hospital admission rates for respiratory causes. Methods This is a retrospective cohort study. We identified all live‐born preterm infants in California from 2007 to 2012 in a population‐based administrative data set and linked them to a data set measuring several air quality and sociodemographic indicators at the census tract level. All sociodemographic and air quality predictors were divided into quartiles (first quartile most favourable to the fourth quartile least favourable). Mixed effect logistic models to account for clustering at the census tract level were used to investigate associations between chronic air quality and sociodemographic indicators respiratory hospital admission during the first year of life. Results Of 205 178 preterm infants, 5.9% (n = 12 033) were admitted to the hospital for respiratory causes during the first year. In the univariate analysis, comparing the first to the fourth quartile of chronic ozone (risk ratio [RR] 1.29, 95% confidence interval [CI] 1.21, 1.37), diesel (RR 1.10, 95% CI 1.02, 1.17) and particulate matter 2.5 (RR 1.07, 95% CI 1.01, 1.14) exposure were associated with hospital admission during the first year. Following adjustment for confounders, the risk ratios for hospital admission during the first year were 1.53 (95% CI 1.37, 1.72) in relation to educational attainment (per cent of the population over age 25 with less than a high school education) and 1.23 (95% CI 1.09, 1.38) for poverty (per cent of the population living below two times the federal poverty level). Conclusions Among preterm infants, respiratory hospital admissions in the first year in California are associated with socioeconomic characteristics of the neighbourhood an individual is living in.

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Section: Discussionsupporting

confidence: 78%

Section: Commentmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 81%

Section: Backg Rou N Dmentioning

confidence: 99%

See 2 more Smart Citations

Cohort study of respiratory hospital admissions, air quality and sociodemographic factors in preterm infants born in California

Steurer

Costello

Baer

et al. 2020

Paediatric Perinatal Epid

View full text Add to dashboard Cite

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“…(13)(14)(15) Rehospitalisation rates amongst preterms have been found to be significantly higher than those of full-term infants. (16)(17)(18)Factors previously found to be associated with rehospitalisation are male sex (19)(20)(21)(22), lower gestational age (23)(24)(25), low birth weightor being small for gestational age (SGA) (26), feeding problems (27)(28)(29)(30), bronchopulmonary dysplasia (BPD) (31,32)and lower socioeconomic status (21,27,33,34). To the best of our knowledge, the literature on the early rehospitalisation of preterms discussed explanatory models only and not validated predictive models.…”

Section: Introductionmentioning

confidence: 99%

Assessing the risk of early unplanned rehospitalisation in preterm babies: EPIPAGE 2 study

Reed

Morgan²,

Zeitlin

et al. 2019

Preprint

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Background Gaining a better understanding of the probability, timing and prediction of rehospitalisation amongst preterm babies could help improve outcomes. There is limited research addressing these topics amongst extremely and very preterm babies. In this context, unplanned rehospitalisations constitute an important, potentially modifiable adverse event. We aimed to establish the probability, time-distribution and predictability of unplanned rehospitalisation within 30 days of discharge in a population of French preterm babies.Methods This study used data from EPIPAGE 2, a population-based prospective study of French preterm babies. Only those babies discharged home alive and whose parents responded to the 1-year survey were eligible for inclusion in our study. For Kaplan-Meier analysis, the outcome was unplanned rehospitalisation censored at 30 days. For predictive modelling, the outcome was binary, recording unplanned rehospitalisation within 30 days of discharge. Predictors included routine clinical variables selected based on expert opinion.Results Of 3,841 eligible babies, 350 (9.1%, 95% CI 8.2-10.1) experienced an unplanned rehospitalisation within 30 days. The probability of rehospitalisation progressed at a consistent rate over the 30 days. There were significant differences in rehospitalisation probability by gestational age. The cross-validated performance of a ten predictor model demonstrated low discrimination and calibration. The area under the receiver operating characteristic curve was 0.62 (95% CI 0.59-0.65).Conclusions Unplanned rehospitalisation within 30 days of discharge was infrequent and the probability of rehospitalisation progressed at a consistent rate. Lower gestational age increased the probability of rehospitalisation. Predictive models comprised of clinically important variables had limited predictive ability.

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Association of Pediatric Inpatient Socioeconomic Status With Hospital Efficiency and Financial Balance

et al. 2019

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Key PointsQuestionIs a pediatric patient’s socioeconomic status associated with the admitting hospital’s efficiency and financial balance?FindingsIn this cohort study of 4 121 187 pediatric admissions in France, the socioeconomic status of the child was statistically significantly associated with increased length of stay and cost. A disadvantaged case mix was also statistically significantly associated with the financial balance of the hospital.MeaningThese findings suggest that reform of hospital funding to better consider patients’ socioeconomic status and the specificities of pediatric care should be encouraged in France and similar countries that rely on a reimbursement system based on diagnosis related groups.

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Influence of Socioeconomic Context on the Rehospitalization Rates of Infants Born Preterm

Cited by 34 publications

References 26 publications

Cohort study of respiratory hospital admissions, air quality and sociodemographic factors in preterm infants born in California

Cohort study of respiratory hospital admissions, air quality and sociodemographic factors in preterm infants born in California

Assessing the risk of early unplanned rehospitalisation in preterm babies: EPIPAGE 2 study

Association of Pediatric Inpatient Socioeconomic Status With Hospital Efficiency and Financial Balance

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