257491 Factors influencing the risk of potentially avoidable children's hospitalizations in Illinois

Tuesday, October 30, 2012

Martin MacDowell, DrPH, MBA, MS , National Center for Rural Health Professions, University of Illinois Health Sciences Center at Rockford, Rockford, IL
Objectives: To examine risk factors for pediatric hospitalizations due to an ambulatory care sensitive conditions (ACSCs) as well as for three specific pediatric ACSCs (pediatric asthma, pediatric gastroenteritis, or low birth weight.

Methods: AHRQ has defined hospital admissions related to pediatric ACSCs. De-identified inpatient data was obtained from the Illinois Dept. of Public Health. 2003-2007 discharges for 1,292,119. Illinois children less than aged 18 were as to ACSC status. Zip codes are identified as primary care (PC) shortage areas by CMS. Both descriptive and analytic analyses were done using SPSS 19. Generalized Estimating Equations (GEE) were used to analyze the clustered data to examine the impact of study variables on risk of pediatric ACSCs.

Results: Descriptive findings indicate 7.0% of the pediatric discharges were ACSC hospitalizations and the proportion ACSC hospitalizations were similar for males and female (7.0% vs. 7.1%). However, ACSC hospitalizations were higher among urban compared to rural children (7.2% vs. 6.0%) and lower for children residing in versus outside of a PC shortage area (5.8% vs. 7.2%), Chi-square, p <.01. Low Birth Weight and Asthma were the pediatric ACSCs leading to the higher % of ACSC occurring in urban and outside PC shortage zip codes.

Multivariate results will further assess the risk of an ACSC hospitalization related to PC shortages adjusting for covariates (gender, age, and zip code or county level socioeconomic factors). Separate analysis will examine the relationship between study variables and risk of ACSC admissions due to Pediatric Asthma, Pediatric Gastroenteritis, and Low Birth Weight.

Learning Areas:
Program planning
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
1) Identify and describe factors associated with risk of potentially avoidable children's hospital admissions that are termed Ambulatory Care Sensitive Conditions (ACSC) hospitalizations and related patterns in Illinois 2) Describe findings related to the relationship of the supply of primary care within the zip code of the child's residence and other individual and socioeconomic variables as predictors of children's ACSC hospitalization risk controlling for patient age and gender. 3) Discuss policy interventions suggested by the analyses that could reduce preventable hospitalizations among Illinois children.

Keywords: Children, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have previous publications and presentations related to child health issues and examination of factors influencing preventable hospitalization. I am involved in primary care workforce development and have special interest improving access to care in rural areas.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.