ArticleMaternal and child health journal2022
Association Between Neighborhood Disadvantage and Pediatric Readmissions.
Article in Maternal and child health journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Area Deprivation Index as an Additive Marker of Postdischarge Care Vulnerability in Pediatric Acute Hematogenous Osteomyelitis.Journal of the Pediatric Orthopaedic Society of North America · 2026Article
- Unplanned Readmissions in Pediatric Cardiac Disease: Impacts of Social Determinants of Health.Pediatric cardiology · 2026Article
- Neighborhood Socioeconomic Deprivation Associates with Decreased Serologic Normalization Rates in Pediatric Celiac Disease.The Journal of pediatrics · 2025Article
- Area-Level Socioeconomic Disadvantage and Post-PICU Outcomes in Children With an Acquired Brain Injury: Single-Center Retrospective Cohort, 2016-2023.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025Article
- Toward digital caregiving network interventions for children with medical complexity living in socioeconomically disadvantaged neighborhoods.JAMIA open · 2025Article
- Racial Disparities and Achievement of the Low Lupus Disease Activity State: A CARRA Registry Study.Arthritis care & research · 2025Article
- Impact of Neighborhood Disadvantage on Preventive and Acute Care Utilization in Sickle Cell Disease.Pediatric blood & cancer · 2025Article
- Sociodemographic Factors are Associated with Care Delivery and Outcomes in Pediatric Severe Sepsis.Critical care explorations · 2024Article
- Dementia Risk and Disadvantaged Neighborhoods.JAMA neurology · 2023Article
- Children with severe sepsis: relationship between community level income and morbidity and mortality.Pediatric research · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveAlthough individual-level social determinants of health (SDH) are known to influence 30-day readmission risk, contextual-level associations with readmission are poorly understood among children. This study explores associations between neighborhood disadvantage measured by Area Deprivation Index (ADI) and pediatric 30-day readmissions.
methodsThis retrospective cohort study included discharges of patients aged < 20 years from Maryland's 2013-2016 all-payer dataset. The ADI, which quantifies 17 indicators of neighborhood socioeconomic disadvantage within census block groups, is used as a proxy for contextual-level SDH. Readmissions were identified with the 30-day Pediatric All-Condition Readmissions measure. Associations between ADI and readmission were identified with generalized estimating equations adjusted for patient demographics and clinical severity (Chronic Condition Indicator [CCI], Pediatric Medical Complexity Algorithm [PMCA], Index Hospital All Patients Refined Diagnosis Related Groups [APR-DRG]), and hospital discharge volume.
resultsDischarges (n = 138,998) were mostly female (52.7%), publicly insured (55.1%), urban-dwelling (93.0%), with low clinical severity levels (0-1 CCIs [82.3%], minor APR-DRG severity [48.4%]). Overall readmission rate was 4.0%. Compared to the least disadvantaged ADI quartile, readmissions for the most disadvantaged quartile were significantly more likely (aOR 1.19, 95% CI 1.09-1.30). After adjustment, readmissions were associated with public insurance and indicators of medical complexity (higher number of CCIs, complex-chronic disease PMCA, and APR-DRG severity).
conclusionIn this all-payer, statewide sample, living in the most socioeconomically disadvantaged neighborhoods independently predicted pediatric readmission. While the relative magnitude of neighborhood disadvantage was modest compared to medical complexity, disadvantage is modifiable and thus represents an important consideration for prevention and risk stratification efforts.
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