TY - JOUR
T1 - Do Unmet Health Needs Drive Pediatric Emergency Department Utilization? A Population-Based Assessment
AU - Sojar, Sakina
AU - Gjelsvik, Annie
AU - Tsao, Hoi See
AU - Amanullah, Siraj
N1 - Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Objective: Lack of access to basic health services is thought to increase emergency department (ED) utilization. This study assessed the relationship between unmet health care needs and pediatric ED utilization in the United States. Methods: The National Survey of Children's Health was used (2016–2017; n = 71,360). Parent/guardians reported number of ED visits and the presence of unmet health needs (medical, dental, mental health, vision, hearing, other) in the last 12 months. Associations were analyzed using multinomial logistic regression modeling and accounted for the weighting and complex survey design of the National Survey of Children's Health. Results: Children with 2 or more unmet health needs had 3.72 times (95% confidence interval, 2.25–6.16) risk of ≥2 ED visits when compared with those with 0 unmet health needs. This risk became nonsignificant when adjusted for race, ethnicity, age, insurance, having asthma, current medication status, health description, number of preventative health visits, and place to go for preventative health (aRR, 1.77; 95% confidence interval, 0.96–3.27). The adjusted association was also nonsignificant for specific types of unmet needs. Race, insurance status, age 0 to 3 years, current medication status, having asthma, ≥2 preventative visits, and poorer health were associated with ≥2 ED visits. Conclusions: Unmet health needs were not found to be a significant driving force for ED utilization. Other factors were found to be more strongly associated with it. Future studies to understand the perception, motives, and complex interaction of various factors leading to ED use in high-risk populations may optimize care for these children.
AB - Objective: Lack of access to basic health services is thought to increase emergency department (ED) utilization. This study assessed the relationship between unmet health care needs and pediatric ED utilization in the United States. Methods: The National Survey of Children's Health was used (2016–2017; n = 71,360). Parent/guardians reported number of ED visits and the presence of unmet health needs (medical, dental, mental health, vision, hearing, other) in the last 12 months. Associations were analyzed using multinomial logistic regression modeling and accounted for the weighting and complex survey design of the National Survey of Children's Health. Results: Children with 2 or more unmet health needs had 3.72 times (95% confidence interval, 2.25–6.16) risk of ≥2 ED visits when compared with those with 0 unmet health needs. This risk became nonsignificant when adjusted for race, ethnicity, age, insurance, having asthma, current medication status, health description, number of preventative health visits, and place to go for preventative health (aRR, 1.77; 95% confidence interval, 0.96–3.27). The adjusted association was also nonsignificant for specific types of unmet needs. Race, insurance status, age 0 to 3 years, current medication status, having asthma, ≥2 preventative visits, and poorer health were associated with ≥2 ED visits. Conclusions: Unmet health needs were not found to be a significant driving force for ED utilization. Other factors were found to be more strongly associated with it. Future studies to understand the perception, motives, and complex interaction of various factors leading to ED use in high-risk populations may optimize care for these children.
KW - Factors for ED use
KW - Mental health needs
KW - Unmet health needs
KW - Utilization
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U2 - 10.1097/PEC.0000000000002319
DO - 10.1097/PEC.0000000000002319
M3 - Article
C2 - 33635045
AN - SCOPUS:85123969969
SN - 0749-5161
VL - 38
SP - E569-E574
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 2
ER -