Association of Social Determinants With Children’s Hospitals’ Preventable Readmissions Performance

Sills, Marion R.; Hall, Matt; Colvin, Jeffrey D.; Macy, Michelle L.; Cutler, Gretchen J.; Bettenhausen, Jessica L.; Morse, Rustin B.; Auger, Katherine A.; Raphael, Jean L.; Gottlieb, Laura M.; Fieldston, Evan S.; Shah, Samir S.

doi:10.1001/jamapediatrics.2015.4440

Cited by 78 publications

(59 citation statements)

References 23 publications

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“…Were we to base performance measures on ED return visits or return admissions, especially if tied to reimbursement penalties, we run the risk of penalizing hospitals for factors largely outside their control. This is likely to disproportionately penalize hospitals serving vulnerable populations, particularly patients with limited access to health care elsewhere . Another potential unintended consequence is that penalizing ED return visits might encourage ED physicians to admit more patients to reduce return visits.…”

Section: Discussionmentioning

confidence: 99%

Return Visit Admissions May Not Indicate Quality of Emergency Department Care for Children

Sills

Macy

Kocher

et al. 2017

Academic Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Return Visit Admissions May Not Indicate Quality of Emergency Department Care for Children

Sills

Macy

Kocher

et al. 2017

Academic Emergency Medicine

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“…29 As hospital quality metrics rely on administrative data, neighborhood characteristics are frequency utilized. 30,31 In pediatrics, there is a paucity of information about how a patient’s neighborhood correlates with patient or family attributes. Here, we further such an understanding, providing analyses that informs the use of neighborhood-level data in patient-level risk assessment and risk identification.…”

Section: Discussionmentioning

confidence: 99%

Using Address Information to Identify Hardships Reported by Families of Children Hospitalized With Asthma

Auger

Kahn

Simmons

et al. 2017

Academic Pediatrics

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Objective Socioeconomic hardship is common among children hospitalized for asthma but often not practically measurable. Information on where a child resides is universally available. We sought to determine the correlation between neighborhood-level socioeconomic data and family-reported hardships. Methods Caregivers of 774 children hospitalized with asthma answered questions regarding income, financial strain, and primary care access. Addresses were geocoded and linked to zip code-, census tract-, and block group-level (neighborhood) data from the U.S. Census. We then compared neighborhood median household income to family-reported household income; percentage of neighborhood residents living in poverty to family-reported financial strain; and percentage of neighborhood households without an available vehicle to family-reported access to primary care. We constructed heat maps and quantified correlations using Kendall’s rank correlation coefficient. Receiver operator characteristic curves were used to assess predictive abilities of neighborhood measures. Results The cohort was 57% African American and 73% publicly-insured; 63% reported income <$30,000, 32% endorsed ≥4 financial strain measures, and 38% reported less than adequate primary care access. Neighborhood median household income was significantly and moderately correlated with and predictive of reported household income; neighborhood poverty was similarly related to financial strain; neighborhood vehicle availability was weakly correlated with and predictive of primary care access. Correlations and predictions provided by zip code measures were similar to those of census tract and block group. Conclusions Universally available neighborhood information may help efficiently identify children and families with socioeconomic hardships. Systematic screening with area-level socioeconomic measures has the potential to inform resource allocation more efficiently.

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“…In total, it is estimated that the social, environmental and behavioral factors that make up the SDOH account for nearly 75% of one’s health (CDC, 2014). Additionally, poor SDOH are risk factors for costly hospital readmission rates (Sills et al, 2016). …”

Section: Clinical Problemmentioning

confidence: 99%

An Integrative Review of Social Determinants of Health Assessment and Screening Tools Used in Pediatrics

Morone

2017

Journal of Pediatric Nursing

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Problem Social and physical contexts which make up social determinants of health (SDOH) have tremendous impacts on youth development, health and well-being. Despite knowledge and evidence of these impacts, few pediatric SDOH screening tools are known. The purpose of this review was to identify and evaluate available pediatric SDOH screening tools. Eligibility Criteria Articles were limited to studies in the English language, with pediatric populations, conducted in the United States, and were peer-reviewed, primary studies. Sample Search of 3 databases (PsychInfo, CINAHL and PubMed) yielded 499 articles, 486 were excluded. Total of 13 articles were appraised and synthesized using the SDOH framework outlined by Healthy People 2020. Results Thirteen articles relevant to the assessment of SDOH domains were evaluated. Majority of studies were limited in both the number of SDOH domains screened and the depth of screening. Tools were heterogeneous in methods used to assess SDOH risks and few were validated. Limited number of studies included youth or families in the initial development of tools. Conclusions Despite growing recognition across healthcare that SDOH greatly influence pediatric health risks, management and outcomes, there is a dearth of available high quality, multidimensional, comprehensive screening tools for pediatric care professionals. Implications This review emphasizes the need for the continued development of effective, comprehensive and practical tools for assessing pediatric SDOH risk factors. Pediatric nursing care includes the assessment of the youth and family context to effectively evaluate resource needs. Pediatric nurses are well poised to address this knowledge and resource gap.

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Association of Social Determinants With Children’s Hospitals’ Preventable Readmissions Performance

Cited by 78 publications

References 23 publications

Return Visit Admissions May Not Indicate Quality of Emergency Department Care for Children

Return Visit Admissions May Not Indicate Quality of Emergency Department Care for Children

Using Address Information to Identify Hardships Reported by Families of Children Hospitalized With Asthma

An Integrative Review of Social Determinants of Health Assessment and Screening Tools Used in Pediatrics

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