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Residence predicts pediatric hospitalizations for bronchiolitis, pneumonia
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A child’s home address in a low socioeconomic status area was predictive of future bronchiolitis or pneumonia hospitalization, according to recent study data.
“Hospitalization rates for bronchiolitis and pneumonia showed substantial variation across census tracts within a single U.S. county,” Samir S. Shah, MD, MSCE, of the department of pediatrics at Cincinnati Children’s Hospital and an Infectious Diseases in Children Editorial Board member, and colleagues wrote. “This variability was significantly associated with underlying differences in census tract–level socioeconomic status.”
Samir S. Shah
The researchers studied children aged younger than 2 years with bronchiolitis and those aged younger than 18 years with pneumonia admitted to the hospital from 2010 to 2013. Diagnoses were compared with each child’s home address to study the association between location and hospitalization.
The researchers divided the 222 census tracts in Hamilton County, Ohio, into five groups based on hospitalization rates. The groups with the greatest hospitalization rate were located in the county’s lowest socioeconomic status areas. The highest median hospitalization rate for bronchiolitis reported was approximately six times greater, with 32.8 cases per 1,000 children per year vs. the lowest quintile at 5.1 cases per 1,000 children per year. The median income for a household of four among those with the greatest hospitalization rate for bronchiolitis was equal to the federal poverty level.
Results followed the same trend for children aged younger than 18 years diagnosed with pneumonia, with 3.3 cases per 1,000 children annually in the highest group compared with the lowest group at 0.3 cases per 1,000 children annually.
The researchers said hot spots for both pneumonia and bronchiolitis were more prominent in urban areas, whereas hospitalization cold spots were more likely to be in outlying affluent suburbs.
“Clinical and public health interventions should be targeted in ways that aim to ‘cool’ areas at high risk of excessive hospital utilization, resulting in improved patient outcomes at decreased cost,” Shah and colleagues wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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