141st APHA Annual Meeting and Exposition

In This section

278769
Unmet healthcare need among US children increases subsequent ambulatory care sensitive utilization

Monday, November 4, 2013 : 10:40 AM - 10:50 AM

Lauren E. Wisk, BS , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Whitney P. Witt, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Ambulatory care sensitive (ACS) emergency room and inpatient utilization is costly and may contribute to worse health outcomes. We sought to determine if unmet healthcare need was associated with ACS utilization among children in the US, using a nationally representative, population-based sample. We examined data on 22,581 children (age 0-17) from the 2002-2007 Medical Expenditure Panel Survey. Unmet need was defined as delayed or forgone healthcare during the first survey year. ACS utilization during the second survey year was evaluated using standard algorithms. Multivariable logistic regression was used to determine if children who experienced unmet need were more likely to have any ACS utilization in the following year, adjusting for relevant covariates. Overall, 3.12% of children experienced any ACS utilization, and 5.96% of children experienced any unmet need. The unadjusted rate of ACS utilization among children with unmet need was 4.77%, compared to 3.02% for those without unmet need (p<0.01). Children who experienced any unmet healthcare need during the first survey year had 69% higher odds of any ACS utilization during the second survey year (95% CI: 1.15-2.49), adjusting for health insurance, usual source of care, family income and sociodemographics. Additional disparities existed. As ACS utilization was associated with prior unmet need for US children, families may be substituting prior delayed or forgone ambulatory care with emergency room and inpatient care. Reducing unmet need may improve health outcomes for children by increasing their opportunity to receive timely and appropriate preventive care, rather than more costly acute care.

Learning Areas:
Biostatistics, economics
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the association between unmet healthcare need and future ambulatory care sensitive emergency room and inpatient utilization among children in the US; Identify a potential pathway leading from poor access to care to health disparities in health services use and health outcomes among children in the US

Keywords: Access and Services, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived the research question, compiled the data, and conducted all analyses for this project.
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.