ArticlePloS one2024
Clinical and socioeconomic predictors of hospital use and emergency department visits among children with medical complexity: A machine learning approach using administrative data.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Digital Health Technology Applications in Home Care for Children With Complex Medical Conditions: A Scoping Review.Journal of advanced nursing · 2026Article
- Rural-Urban Differences in Emergency Department Choice for Children With Medical Complexity, 2012-2017.Pediatric emergency care · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe primary objective of this study was to identify clinical and socioeconomic predictors of hospital and ED use among children with medical complexity within 1 and 5 years of an initial discharge between 2010 and 2013. A secondary objective was to estimate marginal associations between important predictors and resource use.
methodsThis retrospective, population-cohort study of children with medical complexity in Alberta linked administrative health data with Canadian census data and used tree-based, gradient-boosted regression models to identify clinical and socioeconomic predictors of resource use. Separate analyses of cumulative numbers of hospital days and ED visits modeled the probability of any resource use and, when present, the amount of resource use. We used relative importance in each analysis to identify important predictors.
resultsThe analytic sample included 11 105 children with medical complexity. The best short- and long-term predictors of having a hospital stay and number of hospital days were initial length of stay and clinical classification. Initial length of stay, residence rurality, and other socioeconomic factors were top predictors of short-term ED use. The top predictors of ED use in the long term were almost exclusively socioeconomic, with rurality a top predictor of number of ED visits. Estimates of marginal associations between initial length of stay and resource use showed that average number of hospital days increases as initial length of stay increases up to approximately 90 days. Children with medical complexity living in rural areas had more ED visits on average than those living in urban or metropolitan areas.
conclusionsClinical factors are generally better predictors of hospital use whereas socioeconomic factors are more predictive of ED use among children with medical complexity in Alberta. The results confirm existing literature on the importance of socioeconomic factors with respect to health care use by children with medical complexity.
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