Where children live linked to delayed access to surgical care
More resources to neighborhoods needed to improve equitable access to healthcare

Date:
February 16, 2022
Source:
Ann & Robert H. Lurie Children's Hospital of Chicago
Summary:
A new study found that children from less resourced neighborhoods
were at increased odds of presenting with complicated appendicitis,
an indicator of delayed access to surgical care. This is the
first pediatric study to link many neighborhood-level factors that
influence health -- such as quality of schools, housing, safety,
and economic opportunity -- to timely surgical care access.



FULL STORY ==========================================================================
A new study from Ann & Robert H. Lurie Children's Hospital of Chicago
found that children from less resourced neighborhoods were at increased
odds of presenting with complicated appendicitis, an indicator of delayed access to surgical care. This is the first pediatric study to link many neighborhood- level factors that influence health -- such as quality of schools, housing, safety, and economic opportunity -- to timely surgical
care access. Findings are published in the journal JAMA Network Open.


========================================================================== "Timely access to pediatric surgical care may help reduce the need for emergency surgery, long hospital stays, or admission to the intensive care unit," said co-author Fizan Abdullah, MD, PhD, Division Head of Pediatric Surgery at Lurie Children's and Professor of Surgery at Northwestern
University Feinberg School of Medicine. "Most importantly, our findings
may help in developing policies and programs to increase community
opportunity and ensure that all children, no matter where they live, gain equitable access to surgical care." For the retrospective, cohort study,
the researchers examined the association between neighborhood factors
and the odds of presenting with complicated appendicitis, as well as
the likelihood of unplanned visits or readmissions to the emergency
department with either simple or complicated appendicitis.

Neighborhood-level social determinants of health (SDoH) were measured
by the Child Opportunity Index (COI), a validated Zip code-level index
score derived from 29 independent indicators that are known to affect children's health and development.

The study examined 67,489 patients age 18 and younger who had
appendicitis. The results showed that children from lower COI
neighborhoods had up to 28 percent increased odds of presenting
with complicated appendicitis compared to those from the highest COI neighborhoods. There was no significant association between neighborhood opportunity levels and the odds of unplanned post- discharge healthcare utilization.

"Several large insurance companies have already started addressing the
effect of these social determinants of health through direct investments
in neighborhoods, and this study helps inform the allocation of these investments to increase children's access to care," said senior author
Hassan M.K.

Ghomrawi, PhD, MPH, Research Scientist at Lurie Children's and Associate Professor of Surgery, Medicine, and Pediatrics at Northwestern University Feinberg School of Medicine.

"The lack of association between neighborhood-level factors and unplanned
post- discharge hospitalizations and Emergency Department visits suggests
that once patients have established care, they are connected to a
pediatric resource that can support families after discharge, regardless
of the patient's neighborhood," said lead author Megan Bouchard, MD,
MPH, fourth year surgical resident at Georgetown University Hospital
and former post-doctoral research fellow at Lurie Children's.

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Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Megan E. Bouchard, Kristin Kan, Yao Tian, Mia Casale, Tracie Smith,
Christopher De Boer, Samuel Linton, Fizan Abdullah, Hassan M. K.

Ghomrawi. Association Between Neighborhood-Level Social Determinants
of Health and Access to Pediatric Appendicitis Care. JAMA Network
Open, 2022; 5 (2): e2148865 DOI: 10.1001/jamanetworkopen.2021.48865 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220216112202.htm

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