Children from undercrowded communities are at increased risk of getting into pediatric intensive care and dying there

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Poor children at risk of death in pediatric intensive care. Credit: ATS

According to a study published at the ATS 2022 International Conference, hospitalized children covered by Medicaid living in the poorest areas are at increased risk of being admitted to the Pediatric Intensive Care Unit (PICU) and dying there. The researchers also found higher mortality rates among black children treated in PICU wards.

“We decided to conduct this study because there is already substantial evidence of an increase in PICU’s admissions children coming from underserved areas, but there are currently no studies to test whether children from underserved areas are at greater risk of death, “said presentation author Hannah Mitchell, BMBS Master, BMBS, Evelyn Children’s Hospital, London “We believe this is an important area that needs to be explored to help us understand which children we care for at PICU are at greatest risk.”

Dr. Mitchell and his colleagues studied data on Medicaid claims collected between 2007 and 2014 in 12 U.S. states. They then reviewed patients ’zip codes to identify areas of local socioeconomic deprivation. The researchers determined that the main variable they would study was the percentage of the population living less than 150 percent of poverty line. They then divided these patients into four groups (quartiles) depending on the family income – from the lowest to the highest. They identified admission to the PICU using CPT codes – numbers assigned to specific health services and treatments. The team calculated the chances of entering the PICU and the chances of death for children enrolled in the PICU.

The study included 4,076,675 pediatric patients (under 21 years of age), of whom 274,782 were admitted to the PICU. The mean age of PICU patients was four years, with 68.5 percent having chronic, complex disease. Most PICU patients were identified as white (43.5 percent) or black (32.1 percent). PICU patients with the highest mortality were from the highest poverty quarter, and patients from the lower poverty quarter had the lowest mortality rate. Black children had the highest chances of both PICU admission and mortality.

Dr Mitchell said: “It is clear that children living in unserved areas and in racial or ethnic minority groups are at greater risk of death in intensive care. It is important that physicians working in this field understand this and investigate why it occurs. Understanding the scale of the problem, whether it is worse in some regions, and thinking about why it exists are the first steps towards solving it. “

“I hope it can convince politicians improve access to health care and think about interventions in society that can help address inequality before children are admitted to hospital. We could also investigate health care systems that have lower levels of disparity results and see than they differ. The best real outcome of our findings would be if we could intervene in hospital settings to try to improve the performance of these high-risk children. ”

Dr. Mitchell and his colleagues noted that further work is needed to understand the racial differences they have identified and whether these differences can be eliminated in hospital conditions.

“The next important step in working for health equity is to go beyond simply describing disparities to intervene to address them. There are several factors that affect the disparities in the health of children living in underserved areas, including the presence of a basic state of ill health or a higher risk of serious accidents that may force them to go to the hospital.Children coming from unserved areas are more likely to receive care in low-quality hospitals. hospital, some children may be more likely to treat doctors differently. Further research is needed to understand which of these is a major factor in the different outcomes so that targeted interventions can be developed to try to help deal with the problem. ”


Some children with COVID-19 require admission to the PICU department


Additional information:
www.abstractsonline.com/pp8/#! … 76 / presentation / 7555

Citation: Children in underserved communities are at increased risk of pediatric intensive care and death there (2022, May 17) received May 17, 2022 from https://medicalxpress.com/news/2022-05-children-underserved- pediatric -icu-dying.html

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