Lower child opportunity index is associated with increased healthcare utilization following pediatric liver transplantation.

Abstract

Social determinants of health (SDOH) are known to lead to adverse health outcomes, including high acute care utilization. The mechanisms underlying healthcare disparities among children who have undergone liver transplantation (LT) are poorly understood. To elucidate the relationship between SDOH and healthcare utilization among children (<18 y old at time of LT) who have undergone LT, we performed a retrospective study merging data from the Organ Procurement and Transplantation Network (OPTN) and the Pediatric Hospital Information System (PHIS) database. Children with lower Child Opportunity Index (COI) scores, a composite measure of SDOH, were admitted for 28% more days in the first year and 29% more days over the first two years post-LT, as compared to children with higher COI. We also observed that in the second year post-LT, children with a lower COI were more often admitted with a complication of LT (23%) than those with a higher COI (18%). COI may be a useful composite screening instrument for clinical teams to target resources and limit acute care use post-LT.