by Leigh MacMillan
Children with medical complexity (CMC) — children with one or more complex chronic conditions — who live in low opportunity areas utilize more acute care than those who live in higher opportunity areas, according to a new study in the Journal of Hospital Medicine.
Cristin Fritz, MD, MPH, and colleagues used the Pediatric Health Information Systems database to identify emergency department encounters or inpatient admissions from 2016-2019 for 23,197 CMC ages 28 days to 16 years at the time of the initial encounter in 2016.
They analyzed associations between the Child Opportunity Index 2.0 (COI), a national ZIP code-level metric of conditions relevant to healthy childhood development, and hospital utilization days. Utilization days in the lowest COI group were 47.1 and decreased stepwise to 38.6 in the highest COI group.
The findings support the development of hospital- and community-based interventions aimed at addressing the increased vulnerability of CMC from low COI areas and improving child health outcomes.
Other authors of the study from Monroe Carell Jr. Children’s Hospital at Vanderbilt include Katherine Freundlich, MD, Dena Ibrahim, MD, James Gay, MD, MMHC, Alison Carroll, MD, Maya Neeley, MD, Patricia Frost, MD, Alison Herndon, MD, MSPH, Allysa Kehring, MD, and Derek Williams, MD, MPH. The research was supported in part by the Agency for Healthcare Research and Quality (grant HS026122).
