Predicting the preventable: Social drivers of health on pediatric readmissions and emergency department visits.

IF 3.2 2区心理学 Q1 PSYCHOLOGY

Health Psychology Pub Date : 2025-11-01 Epub Date: 2025-06-02 DOI:10.1037/hea0001529

Kristen A Torres, Doris Valenzuela-Araujo, Michael A Harris, Nathan F Dieckmann, Joanna Galindo, Louise Elaine Vaz, David V Wagner

{"title":"Predicting the preventable: Social drivers of health on pediatric readmissions and emergency department visits.","authors":"Kristen A Torres, Doris Valenzuela-Araujo, Michael A Harris, Nathan F Dieckmann, Joanna Galindo, Louise Elaine Vaz, David V Wagner","doi":"10.1037/hea0001529","DOIUrl":null,"url":null,"abstract":"Objective: This study aimed to examine the extent to which pediatric emergency department visits and admissions are preventable and whether caregiver-reported social factors predict future preventable visits.Method: Caregivers of hospitalized children (N = 249) completed a predischarge survey regarding health care utilization and social drivers of health (e.g., adverse childhood experiences and experiences of racial discrimination). Chart reviews were conducted 365 days postdischarge to capture the presence and frequency of acute medical events (AMEs; i.e., readmissions and emergency department visits). Three methods of determining the preventability of AMEs were used to examine the relationship between preventable AMEs and medical status, demographic characteristics, and social drivers of health.Results: Of the youth who experienced an AME, over half (67%) experienced one or more events classified as \"preventable\" by at least one method. Statistically significant predictors associated with preventable events included age under 1 (OR = 4.17), complex/chronic medical status (OR = 3.03), other children in the home with health concerns (OR = 1.85), and the presence of a neurocognitive disorder (OR = 2.97). Higher caregiver education (incidence rate ratio [IRR] = 0.31) was related to fewer preventable events overall. Child mental health condition (IRR = 18.62), having a deceased caregiver (IRR = 4.35), and child experiences of racial or ethnic discrimination (IRR = 6.01) were related to more preventable readmissions.Conclusion: A substantial number of AMEs may be preventable. Caregiver reports of social factors should be included in risk assessments to inform tailored interventions and discharge plans based on unique family characteristics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":55066,"journal":{"name":"Health Psychology","volume":" ","pages":"1063-1073"},"PeriodicalIF":3.2000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/hea0001529","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: This study aimed to examine the extent to which pediatric emergency department visits and admissions are preventable and whether caregiver-reported social factors predict future preventable visits.

Method: Caregivers of hospitalized children (N = 249) completed a predischarge survey regarding health care utilization and social drivers of health (e.g., adverse childhood experiences and experiences of racial discrimination). Chart reviews were conducted 365 days postdischarge to capture the presence and frequency of acute medical events (AMEs; i.e., readmissions and emergency department visits). Three methods of determining the preventability of AMEs were used to examine the relationship between preventable AMEs and medical status, demographic characteristics, and social drivers of health.

Results: Of the youth who experienced an AME, over half (67%) experienced one or more events classified as "preventable" by at least one method. Statistically significant predictors associated with preventable events included age under 1 (OR = 4.17), complex/chronic medical status (OR = 3.03), other children in the home with health concerns (OR = 1.85), and the presence of a neurocognitive disorder (OR = 2.97). Higher caregiver education (incidence rate ratio [IRR] = 0.31) was related to fewer preventable events overall. Child mental health condition (IRR = 18.62), having a deceased caregiver (IRR = 4.35), and child experiences of racial or ethnic discrimination (IRR = 6.01) were related to more preventable readmissions.

Conclusion: A substantial number of AMEs may be preventable. Caregiver reports of social factors should be included in risk assessments to inform tailored interventions and discharge plans based on unique family characteristics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

查看原文本刊更多论文

预测可预防：儿童再入院和急诊科就诊健康的社会驱动因素。

目的：本研究旨在探讨儿科急诊科就诊和入院可预防的程度，以及护理人员报告的社会因素是否能预测未来可预防的就诊。方法：对249例住院儿童的护理人员进行出院前医疗保健利用和健康的社会驱动因素（如童年不良经历和种族歧视经历）调查。出院后365天进行图表审查，以了解急性医疗事件的存在和频率(AMEs；即再入院和急诊室就诊)。采用三种确定AMEs可预防性的方法来检验可预防AMEs与医疗状况、人口特征和健康的社会驱动因素之间的关系。结果：在经历AME的青少年中，超过一半（67%）经历了至少一种方法可以“预防”的一个或多个事件。与可预防事件相关的具有统计学意义的预测因子包括1岁以下（OR = 4.17）、复杂/慢性医疗状况（OR = 3.03）、家中其他有健康问题的儿童（OR = 1.85）和存在神经认知障碍（OR = 2.97）。护理人员教育程度越高（发病率比[IRR] = 0.31），总体上可预防事件越少。儿童心理健康状况（IRR = 18.62）、有已故照顾者（IRR = 4.35）和儿童种族或民族歧视经历（IRR = 6.01）与更多可预防的再入院相关。结论：相当数量的AMEs是可以预防的。护理人员的社会因素报告应包括在风险评估中，以根据独特的家庭特征为量身定制的干预措施和出院计划提供信息。（PsycInfo Database Record (c) 2025 APA，版权所有）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Health Psychology 医学-心理学

CiteScore

4.90

自引率

2.40%

发文量

170

审稿时长

4-8 weeks

期刊介绍： Health Psychology publishes articles on psychological, biobehavioral, social, and environmental factors in physical health and medical illness, and other issues in health psychology.