WIP 86 - Association of the Childhood Opportunity Index and Social Vulnerability Index with Hospitalization and ICU Utilization in Pediatric Patients with Ambulatory Care Sensitive Conditions

Poster Number: WIP 86
Publication Number: WIP 86.946

Background: Growing evidence supports the association between the Childhood Opportunity Index (COI), Social Vulnerability Index (SVI) and emergency department (ED) utilization and hospitalization for common pediatric illnesses, reinforcing the impact of social and structural determinants of childhood health. Disparity in access to high quality outpatient pediatric care has also been described. In contrast, little is known about the association between COI or SVI and hospitalization or intensive care (ICU) utilization for ambulatory care sensitive conditions (ACSCs) in children.

Objective: We aim to describe the association between COI and SVI with the need for hospitalization and ICU utilization for ACSCs. We hypothesize that children with the lowest COI or highest SVI will be more likely to be hospitalized and more likely to be admitted to the ICU than those with the highest COI or lowest SVI. We suspect that children with higher SVI or lower COI may have less access to quality outpatient care, will be sicker at the time of presentation, and thus more likely to require ICU care.

Design/Methods: Patients < 18 years old presenting to the ED with ACSCs between January 1, 2010 – December 31, 2022 will be included in the study. Patients admitted to the Heart Institute or Neonatal ICU and those who are ventilator dependent will be excluded. Patients will be sorted into cohorts: discharged from the ED, admitted to the pediatric ward, or admitted to the ICU.

COI and SVI will be evaluated as ordinal variables using the quintiles. Univariate analyses will determine which patient baseline characteristics are associated with each outcome. Variables with p-values < 0.1 will be considered for multivariable logistic regression modeling for the outcomes admission to the hospital and ICU. All models will control for significant or clinically relevant patient demographics and clinical variables.

We have obtained IRB approval and are identifying our patient cohorts. We will begin data analysis in November 2023 and will complete our analysis by April 2024.