Observational studyCritical care explorations2026
Exploring the Impact of Child Opportunity on PICU Utilization and the Role of Public Insurance.
Observational study in Critical care explorations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Authors and funding
6 authors.
Funding
Abstract
objectivesPublic insurance reduces financial barriers to healthcare but may not fully mitigate the influence of neighborhood opportunity on pediatric critical care utilization. We examined the association between neighborhood opportunity and PICU utilization, including costs, and assessed whether public insurance modified these relationships.
designPopulation-level retrospective observational study.
settingA single, free-standing quaternary children's hospital in southwestern Ohio. PATIENTS: Children 18 years or younger admitted to the PICU between January 1, 2016, and December 31, 2022, residing within the hospital's primary service area.
interventionsNone. MEASUREMENTS AND MAIN
resultsPrimary outcomes were census tract (CT) level PICU admission rates and median PICU costs. Very low opportunity neighborhoods had the highest PICU admission rates (3.41 vs. 1.76 admissions per 1000 children in very high opportunity neighborhoods; p < 0.001). Overall CT level median PICU costs did not differ by Child Opportunity Index (COI; p = 0.582). Publicly insured children were more likely to reside in very low opportunity neighborhoods (44% vs. 10%; p < 0.001). Within very low opportunity neighborhoods, publicly insured children had lower median PICU costs than children with other insurance ($16,693 vs. $22,585; p = 0.008); costs were similar across insurance groups in other COI quintiles. In multivariable analyses, the interaction between insurance status and neighborhood opportunity was not statistically significant (p = 0.099).
conclusionsChildren from low opportunity neighborhoods experienced higher PICU admission rates, while neighborhood opportunity and public insurance jointly influenced patterns of PICU resource utilization. Expanding insurance coverage alone is unlikely to eliminate disparities; improving neighborhood conditions and implementing place-based strategies may help mitigate PICU utilization.
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