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- Title
Association between Gaps in Care Coordination and Emergency Department Visits Among Children without Chronic Conditions or Special Needs.
- Authors
Rajan, Mangala; Abramson, Erika L.; Pinheiro, Laura C.; Kern, Lisa M.
- Abstract
Objective: Prior studies and have shown that gaps in care coordination (CC) increase the risk of emergency department (ED) visits among children with special healthcare needs. This study aims to determine if gaps in CC are associated with an increased risk of ED visits among children without special needs (non-CSHCN). Study Design: We conducted a cross-sectional study using the National Survey of Children's Health (2018–2019), representing children up to age 17. A "gap" in CC occurs if the adult proxy reported dissatisfaction with communication between providers or difficulty getting the help needed to coordinate care for the child. Using logistic regression models adjusting for age and sex, we measured the association between a gap in CC and 1 or more ED visits during the past 12 months overall and stratified by any special needs. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated. Results: Between 2018 and 2019, 15% of respondents reported a gap in CC and 19.4% of children had at least one ED visit. Among non-CSHCN, these rates were 11% and 17%. In this population, a gap in CC was independently associated with an increased odds of ED use (AOR: 2.14; 95% CI 1.82, 2.52). Conclusions for Practice: Self-reported gaps in ambulatory CC were associated with increased odds of ED visits even among non-CSHCN children with minor illnesses, suggesting that providers need to be aware of potential pitfalls in CC for all children, and ensure that pertinent information is available where needed. Significance: Prior studies and targeted interventions have shown that poor CC is significantly associated with a higher risk of ED visits among children with special needs. Though extremely important, this focus leaves out nearly 80% of the pediatric population, among whom ED utilization is still high. This study finds a new association between poor CC and ED utilization among children without special needs, which can inform the design of future interventions.
- Subjects
RISK assessment; CROSS-sectional method; MEDICAL case management; LOGISTIC regression analysis; OUTPATIENT medical care; HOSPITAL emergency services; DESCRIPTIVE statistics; CHI-squared test; PEDIATRICS; ODDS ratio; DATA analysis software; CONFIDENCE intervals
- Publication
Maternal & Child Health Journal, 2024, Vol 28, Issue 9, p1551
- ISSN
1092-7875
- Publication type
Article
- DOI
10.1007/s10995-024-03942-2