Deprivation Disrupts Clinic Visits, Does Not Increase Hospital Utilization

Published April 2022 | Pediatrics

Children with medical complexity (CMC) living in areas of greater socioeconomic deprivation have higher odds of missing outpatient visits, but such deprivation is not associated with more hospitalizations nor emergency department utilization.

That’s the conclusion of a cross-sectional study led by Joanna Thomson, MD, MPH, Andrew Beck, MD, MPH, and colleagues that involved 512 children with complex conditions receiving care in a Cincinnati Children’s patient-centered medical home. The study found a 13% relative increase in the missed clinic visit rate for every 0.1 unit increase in the Deprivation Index but found no association between area-level deprivation and emergency department visits, hospitalizations, or inpatient bed-days.

The co-authors suggest that the patient-centered concept followed by the Complex Care Center at Cincinnati Children’s may blunt expected increases in hospital utilization caused by poverty and related factors. However, families with children who require complex care still experience barriers to preventive, follow-up appointments.

“To ensure equitable care and outcomes for all children with medical complexity, health systems and providers should seek to understand and address any barriers to care arising from the socioeconomic context in which they live,” Thomson says.

The Cincinnati Children’s community health initiative has been working closely with families and community partners to identify strategies to help children receive the right care at the right time and place, and in the right way.

Watch a video abstract of the findings.