Details:

Alternative Title:
PM R
Personal Author:
Mann, Joshua R. ; Royer, Julie A. ; Turk, Margaret A. ; McDermott, Suzanne ; Holland, Margaret M. ; ... More +
Mann, Joshua R. ; Royer, Julie A. ; Turk, Margaret A. ; McDermott, Suzanne ; Holland, Margaret M. ; Ozturk, Orgul D. ; Hardin, James W. ; Thibadeau, Judy K. Less -
Description:
Objective

To compare emergency room (ER) and inpatient hospital (IP) use rates for persons with spina bifida (SB) to peers without SB, when transition from pediatric to adult health care is likely to occur; and to analyze those ER and IP rates by age, race, socioeconomic status, gender, and type of residential area.

Design

A retrospective cohort study.

Setting

Secondary data analysis in South Carolina.

Participants

We studied individuals who were between 15 and 24 years old and enrolled in the State Health Plan (SHP) or state Medicaid during the 2000–2010 study period.

Methods

Individuals with SB were identified using ICD-9 billing codes (741.0, 741.9) in SHP, Medicaid, and hospital uniform billing (UB) data. ER and IP encounters were identified using UB data. Multivariable Generalized Estimating Equation (GEE) Poisson models were estimated to compare rates of ER and IP use among the SB group to the comparison group.

Main Outcome Measures

Total ER rate and IP rate, in addition to cause-specific rates for ambulatory care sensitive conditions (ACSC) and other condition categories.

Results

We found higher rates of ER and IP use in persons with SB compared to the control group. Among individuals with SB, young adults (those 20–24 years old) had higher rates of ER use due to all ACSC (P = .023), other ACSC (P = .04), and urinary tract infections (UTI; P = .002) compared to adolescents (those 15–19 years old).

Conclusions

Young adulthood is associated with increased ER use overall, as well as in specific condition categories (most notably UTI) in individuals 15–24 years old with SB. This association may be indicative of changing healthcare access as people with SB move from adolescent to adult health care, and/or physiologic changes during the age range studied.


Subjects:
[+]
Adolescent Age Factors Black Or African American Emergency Service, Hospital Female Hospitalization Humans Male Retrospective Studies Sex Factors Socioeconomic Factors Spinal Dysraphism White People Young Adult
Source:
PM R. 2015; 7(5):499-511.
Pubmed ID:
25511690
Pubmed Central ID:
PMC4469995
Document Type:
Journal Article
Funding:
197NICS228/HL/NHLBI NIH HHS/United States ; CC999999/Intramural CDC HHS/United States ; U01 DD000776/DD/NCBDD CDC HHS/United States ; U01-DD000776-02/DD/NCBDD CDC HHS/United States
197NICS228/HL/NHLBI NIH HHS/United States ; CC999999/Intramural CDC HHS/United States ; U01 DD000776/DD/NCBDD CDC HHS/United States ; U01-DD000776-02/DD/NCBDD CDC HHS/United States Less -
Place as Subject:
South Carolina
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:e108c339ce43cebdc42e1cc780426221574419b00bd8934726202b6d6c54b7ad
Download URL:
https://stacks.cdc.gov/view/cdc/31661/cdc_31661_DS1.pdf
File Type:

Supporting Files

• nihms698813.nxml

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