ArticleJournal of hospital medicine2022
Child Opportunity Index 2.0 and acute care utilization among children with medical complexity.
Article in Journal of hospital medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Contextual nonmedical health factors and critical care-related outcomes: a systematic review.Critical care (London, England) · 2025Pooled it
- The Child Opportunity Index and Children's Health: A Meta-Analysis.Pediatrics · 2025Pooled it
- Differences in antibiotic treatment for children hospitalized with pneumonia.Journal of hospital medicine · 2026Article
- Geospatial Access to Pediatric Cardiac and Cardiac-Surgical Services by Neighborhood-Level Determinants of Health.Journal of the American Heart Association · 2026Article
- Utilization of the Child Opportunity Index to Evaluate Timing of Tympanostomy Tube Placement.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Association between Air Pollution, Neighborhood Opportunity, and Pediatric Intensive Care Unit Admissions in Acute Respiratory Illness.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
- Article
- Characterizing Social Communication Difficulties in Young Children within a Longitudinal Ecological Systems Framework.Research on child and adolescent psychopathology · 2025Article
- Toward digital caregiving network interventions for children with medical complexity living in socioeconomically disadvantaged neighborhoods.JAMIA open · 2025Article
- Impact of an Inpatient Social Needs Screening Program: Did Our Referral Resolve Your Need?Hospital pediatrics · 2024Article
- Identifying Precise Targets to Improve Child Mental Health Care Equity: Leveraging Advances in Clinical Research Informatics and Lived Experience.Child and adolescent psychiatric clinics of North America · 2024Review
- Acute care utilization for ambulatory care-sensitive conditions among publicly insured children.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Article
- Long-term follow-up of patients with congenital diaphragmatic hernia.World journal of pediatric surgery · 2024Review
- Intensity of end-of-life care among children with life-threatening conditions: a national population-based observational study.BMC pediatrics · 2023Observational
- Child Opportunity Index and Hospital Utilization in Children With Traumatic Brain Injury Admitted to the PICU.Critical care explorations · 2023Article
- Admitting what is needed: How the health system and society can reduce hospitalizations for children with medical complexity.Journal of hospital medicine · 2023Article
- Association of the Child Opportunity Index and Inpatient Illness Severity in the United States, 2018-2019.Academic pediatricsArticle
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15 authors.
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Abstract
backgroundDisproportionately high acute care utilization among children with medical complexity (CMC) is influenced by patient-level social complexity.
objectiveThe objective of this study was to determine associations between ZIP code-level opportunity and acute care utilization among CMC. DESIGN, SETTING, AND
participantsThis cross-sectional, multicenter study used the Pediatric Health Information Systems database, identifying encounters between 2016-2019. CMC aged 28 days to <16 years with an initial emergency department (ED) encounter or inpatient/observation admission in 2016 were included in primary analyses. MAIN OUTCOME AND MEASURES: We assessed associations between the nationally-normed, multi-dimensional, ZIP code-level Child Opportunity Index 2.0 (COI) (high COI = greater opportunity), and total utilization days (hospital bed-days + ED discharge encounters). Analyses were conducted using negative binomial generalized estimating equations, adjusting for age and distance from hospital and clustered by hospital. Secondary outcomes included intensive care unit (ICU) days and cost of care.
resultsA total of 23,197 CMC were included in primary analyses. In unadjusted analyses, utilization days decreased in a stepwise fashion from 47.1 (95% confidence interval: 45.5, 48.7) days in the lowest COI quintile to 38.6 (36.9, 40.4) days in the highest quintile (p < .001). The same trend was present across all outcome measures, though was not significant for ICU days. In adjusted analyses, patients from the lowest COI quintile utilized care at 1.22-times the rate of those from the highest COI quintile (1.17, 1.27).
conclusionsCMC from low opportunity ZIP codes utilize more acute care. They may benefit from hospital and community-based interventions aimed at equitably improving child health outcomes.
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