Understanding Variation In Nonurgent Pediatric Emergency Department Use In Communities With Concentrated Disadvantage.
Understanding Variation In Nonurgent Pediatric Emergency Department Use In Communities With Concentrated Disadvantage.
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DOI：
10.1377/hlthaff.2020.00675
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Miller E
中科院分区：
文献类型：
--
作者：
Ray KN;Yahner KA;Bey J;Martin KC;Planey AM;Culyba AJ;Miller E
在社会经济和结构上处于集中劣势的社区，儿童去急诊室就诊的非紧急就诊率往往较高。利用宾夕法尼亚州匹兹堡264个人口普查区组的空间回归模型，我们调查了集中劣势区组儿童非紧急急诊就诊率低于预期(低利用率)和高于预期(高利用率)的社会人口学和结构性因素。与高利用街区组相比，低利用街区组拥有两个成年人、高中毕业生、可以使用车辆、住房质量良好和自住住房的家庭比例更高。值得注意的是，无论是在离公共交通或初级保健非常近的家庭的百分比上，还是在儿童健康保险覆盖率方面，低利用率街区组与高利用率街区组都没有显著差异。利益相关者希望减少集中弱势社区家庭的儿科非紧急急诊就诊，应考虑减轻可能影响家庭获得初级保健的经济、时间、交通和健康素养限制的战略。
Children in communities with concentrated socioeconomic and structural disadvantage tend to have elevated rates of nonurgent visits to emergency departments (EDs). Using a spatial regression model of 264 census block groups in Pittsburgh, Pennsylvania, we investigated sociodemographic and structural factors associated with lower-than-expected (“low utilization”) versus higher-than-expected (“high utilization”) nonurgent ED visit rates among children in block groups with concentrated disadvantage. Compared with high-utilization block groups, low-utilization block groups had higher percentages of households with two adults, high school graduates, access to vehicles, sound housing quality, and owner-occupied housing. Notably, low-utilization block groups did not differ significantly from high-utilization block groups either in the percentage of households located within very close proximity to public transit or primary care or in children’s health insurance coverage rates. Stakeholders wishing to reduce pediatric nonurgent ED visits among families in communities of concentrated disadvantage should consider strategies to mitigate financial, time, transportation, and health literacy constraints that may affect families’ access to primary care.
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