Identifying Modifiable Health Care Barriers to Improve Health Equity for Hospitalized Children

K. Casey Lion · Chuan Zhou · Beth E. Ebel · Robert B. Penfold · Rita M. Mangione-Smith

23 citations0/0 files storedHospital Pediatrics

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Health disparities and outcomes Child and Adolescent Health Public Health and Social Inequalities

Abstract

BACKGROUND: Children from socially disadvantaged families experience worse hospital outcomes compared with other children. We sought to identify modifiable barriers to care to target for intervention. METHODS: We conducted a prospective cohort study of hospitalized children over 15 months. Caregivers completed a survey within 3 days of admission and 2 to 8 weeks after discharge to assess 10 reported barriers to care related to their interactions within the health care system (eg, not feeling like they have sufficient skills to navigate the system and experiencing marginalization). Associations between barriers and outcomes (30-day readmissions and length of stay) were assessed by using multivariable regression. Barriers associated with worse outcomes were then tested for associations with a cumulative social disadvantage score based on 5 family sociodemographic characteristics (eg, low income). RESULTS: = 1734) completed follow-up. Nine of 10 barriers were associated with at least 1 worse hospital outcome. Of those, 4 were also positively associated with cumulative social disadvantage: perceiving the system as a barrier (adjusted β = 1.66; 95% confidence interval [CI] 1.02 to 2.30), skill barriers (β = 3.82; 95% CI 3.22 to 4.43), cultural distance (β = 1.75; 95% CI 1.36 to 2.15), and marginalization (β = .71; 95% CI 0.30 to 1.11). Low income had the most consistently strong association with reported barriers. CONCLUSIONS: System barriers, skill barriers, cultural distance, and marginalization were significantly associated with both worse hospital outcomes and social disadvantage, suggesting these are promising targets for intervention to decrease disparities for hospitalized children.

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References

2003Health Care Disparities 2003The PedsQL™* 4.0 as a Pediatric Population Health Measure: Feasibility, Reliability, and Validity 2004When more is not better: the role of cumulative risk in child behavior outcomes 1993Stability of Intelligence from Preschool to Adolescence: The Influence of Social and Family Risk Factors 1987Intelligence Quotient Scores of 4-Year-Old Children: Social-Environmental Risk Factors 2008Racial and Ethnic Disparities in Medical and Dental Health, Access to Care, and Use of Services in US Children 2006Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study 2005The PedsQL™ as a pediatric patient-reported outcome: reliability and validity of the PedsQL™ Measurement Model in 25,000 children

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