MP53-15 AFTER ADJUSTING FOR CLINICAL COMPLEXITY AND SOCIAL DETERMINANTS OF HEALTH, STATE OF RESIDENCE ONLY FACTOR ASSOCIATED WITH HOSPITAL ADMISSIONS AMONG CHILDREN WITH SPINA BIFIDA PRESENTING TO THE EMERGENCY DEPARTMENT

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP53-15 AFTER ADJUSTING FOR CLINICAL COMPLEXITY AND SOCIAL DETERMINANTS OF HEALTH, STATE OF RESIDENCE ONLY FACTOR ASSOCIATED WITH HOSPITAL ADMISSIONS AMONG CHILDREN WITH SPINA BIFIDA PRESENTING TO THE EMERGENCY DEPARTMENT Patrice Basada, Victor M. Kucherov, Teresa L. Russell, Jacob C. Smith, Sally Zimmermann, Elena K. Johnston, M. Sohel Rana, Elaise Hill, Christina P. Ho, Hans G. Pohl, and Briony K. Varda Patrice BasadaPatrice Basada More articles by this author , Victor M. KucherovVictor M. Kucherov More articles by this author , Teresa L. RussellTeresa L. Russell More articles by this author , Jacob C. SmithJacob C. Smith More articles by this author , Sally ZimmermannSally Zimmermann More articles by this author , Elena K. JohnstonElena K. Johnston More articles by this author , M. Sohel RanaM. Sohel Rana More articles by this author , Elaise HillElaise Hill More articles by this author , Christina P. HoChristina P. Ho More articles by this author , Hans G. PohlHans G. Pohl More articles by this author , and Briony K. VardaBriony K. Varda More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003301.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: ED use and admissions among children with Spina Bifida (SB) may be influenced by social determinants of health (SDoH). Childhood opportunity index is a validated proxy measure of SDoH. Our aim was to determine whether or not there is an association between COI level and admission rates among children with SB presenting at our institution’s ED between 2016-2020 and determine clinical and non-clinical factors associated with ED admissions. METHODS: A retrospective single-institution study of children (age <18 years) with SB presenting to the ED between 2016-2020 was performed. Only encounters for SB-related conditions were included. The primary outcome was hospital admission from the ED. Baseline patient factors (sex, age, race/ethnicity, language, insurance, location of residence, distance from the ED, and COI level) and markers of clinical complexity (SB lesion type, lesion functional level, community ambulation status, and ventricular shunt [VS] status) were collected. Our primary exposure was COI level (high vs. low). We performed descriptive statistics and a random intercept mixed effects multivariable logistic regression (to adjust for patient clustering) to determine factors associated with ED admissions. RESULTS: A total of 165 patients accounted for 598 ED encounters between 2016-2020. Nearly a third of encounters (28%) led to admission; 66% of high COI patients were admitted, while 34% of low COI patients were admitted (p=0.2). COI level was not significantly associated with admission on adjusted analysis (0.9 [0.5-1.6], p=0.7). Factors that were associated with admission on unadjusted analysis included age, race/ethnicity, language, insurance, location of residence, community ambulation, and VS status. However, on adjusted analysis, only location of residence was significant for admission. Those with a residence outside of the District of Columbia and Maryland areas were significantly more likely to be admitted (Virginia [VA] OR=3.7, p<0.01 and West VA/Pennsylvania/New Jersey/military [OR=9.6, p=0.049]). CONCLUSIONS: At our institution, approximately one-third of ED visits led to hospital admissions. COI level was not found to be associated with hospital admissions. Location of residence was the only factor significantly associated. This finding may suggest the need for better access to local care and community partnerships with the Spina Bifida program. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e718 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrice Basada More articles by this author Victor M. Kucherov More articles by this author Teresa L. Russell More articles by this author Jacob C. Smith More articles by this author Sally Zimmermann More articles by this author Elena K. Johnston More articles by this author M. Sohel Rana More articles by this author Elaise Hill More articles by this author Christina P. Ho More articles by this author Hans G. Pohl More articles by this author Briony K. Varda More articles by this author Expand All Advertisement PDF downloadLoading ...