ArticlePediatrics2024
Childhood Opportunity Index and Low-Value Care in Children's Hospitals.
Article in Pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- The Association of Neighborhood Disadvantage with Surgical Outcomes and Follow-up Adherence in Patients with Cleft Palate.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026Article
- Pediatric radiology informatics within a larger academic practice.Pediatric radiology · 2026Review
- Paid family leave and reduced acute respiratory infections in young infants: does everyone benefit equally?American journal of epidemiology · 2026Article
- Adherence With Diagnostic Stewardship Guidance and Sociodemographic Characteristics in the PICU.Hospital pediatrics · 2026Article
- Article
- Socioeconomic Status, Race, and Ethnicity in Management of Pediatric Supraventricular Tachycardia.Journal of the American Heart Association · 2025Observational
- Trends in Respiratory Pathogen Testing at US Children's Hospitals.JAMA network open · 2025Article
- Trends in Respiratory Pathogen Testing at US Children's Hospitals.JAMA network open · 2025Article
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15 authors.
Funding
Abstract
BACKGROUND AND
objectiveFew studies have explored the relationship between social drivers of health and pediatric low-value care (LVC). We assessed the relationship between Childhood Opportunity Index (COI) 2.0 and LVC in children's hospitals.
methodsWe applied the Pediatric Health Information System LVC Calculator to emergency and inpatient encounters from July 2021 through June 2022. Proportions with LVC in highest (greatest opportunity) and lowest COI quintiles were compared. Generalized estimating equation logistic regression models were used to analyze LVC trends across COI quintiles.
results842 463 encounters were eligible for 20 LVC measures. Across all measures, odds of LVC increased across increasing COI quintiles (adjusted odds ratio [OR] 1.06, 95% confidence interval [CI] 1.03-1.08). For 12 measures, LVC was proportionally more common in highest versus lowest COI quintile, whereas the reverse was true for 4. Regression modeling revealed increasing LVC as COI increased across all quintiles for 10 measures; gastric acid suppression for infants had the strongest association (OR 1.22, 95% CI 1.17-1.27). Three measures revealed decreasing LVC across increasing COI quintiles; Group A streptococcal testing among children <3 years revealed the lowest OR (0.85, 95% CI 0.73-0.99). The absolute volume of LVC delivered was greatest among low COI quintiles for most measures.
conclusionsLikelihood of LVC increased across COI quintiles for 10 of 20 measures, whereas 3 measures revealed reverse trends. High volumes of LVC across quintiles support a need for broad de-implementation efforts; measures with greater impact on children with lower opportunity warrant prioritized efforts.
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