The Effects of Chronic Disease on Ambulatory Care–Sensitive Hospitalizations for Children or Youth

The Effects of Chronic Disease on Ambulatory Care–Sensitive Hospitalizations for Children or Youth

Phillips C D; Truong C; Kum H C; Nwaiwu O; Ohsfeldt R

Health Services Insights

2019

Adolescence; Adolescent; Age Factors; Ambulatory Care -- In Adolescence; Ambulatory Care -- In Infancy and Childhood; Child; Chronic Disease; Confidence Intervals; Cross Sectional Studies; Data Analysis Software; Descriptive Statistics; Female; Hospitalized; Human; Infant; Logistic Regression; Male; Models; Newborn; Odds Ratio; Patient Discharge; Post Hoc Analysis; Preschool; Probability; Race Factors; ROC Curve; Sex Factors; Statistical; Texas

Considerable research has focused on hospitalizations for ambulatory care–sensitive conditions (ACSHs), but little of that research has focused on the role played by chronic disease in ACSHs involving children or youth (C/Y). This research investigates, for C/Y, the effects of chronic disease on the likelihood of an ACSH. The database included 699 473 hospital discharges for individuals under 18 in Texas between 2011 and 2015. Effects of chronic disease, individual, and contextual factors on the likelihood of a discharge involving an ACSH were estimated using logistic regression. Contrary to the results for adults, the presence of chronic diseases or a complex chronic disease among children or youth was protective, reducing the likelihood of an ACSH for a nonchronic condition. Results indicate that heightened ambulatory care received by C/Y with chronic diseases is largely protective. Two of more chronic conditions or at least one complex chronic condition significantly reduced the likelihood of an ACSH.

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January 2020 List