ArticleCHEST critical care2026
The Cost of Inequity: Financial Burden of Neighborhood Disparities in Pediatric Critical Care Use.
Article in CHEST critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
backgroundDisparities in health care access and use among critically ill pediatric populations disproportionately affect children from marginalized communities, leading to worse health outcomes and increased financial burden. Neighborhood-level factors likely contribute to variations in PICU admission rates, length of stay (LOS), and costs. However, the impact of such factors on PICU costs at the population-level remains understudied. RESEARCH QUESTION: What variations in PICU use (admission rates, prolonged LOS, and PICU costs) exist in low-opportunity neighborhoods compared with high-opportunity neighborhoods? STUDY DESIGN AND
methodsThis population-level retrospective cohort study enrolled patients younger than 18 years admitted to our PICU from January 1, 2016, through December 31, 2022, with residential addresses in the primary service area (specific counties in Ohio, Kentucky, or Indiana). Patient addresses were linked to census tract-level Child Opportunity Index (COI) data. Associations between COI quintiles and PICU use, including admission rates, LOS, PICU costs, and diagnostic patterns, were examined. Bivariate associations were tested using the Wilcoxon rank-sum test. Linear regression models were used to estimate associations between COI and PICU use outcomes, adjusting for chronic complex conditions.
resultsNine thousand six hundred thirty-four PICU encounters occurred among children residing in 491 regional census tracts. Very low-opportunity tracts showed higher PICU admission rates (3.41 per 1,000 children vs 1.76 per 1,000 children) and greater annual PICU cost per child ($92 vs $60) compared with peers in very high-opportunity tracts (
interpretationOur findings suggest that structural inequities and neighborhood conditions contribute to PICU use and potentially avoidable health care costs. Addressing upstream social determinants of health through neighborhood-based investments may reduce PICU use and may advance child health.
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