OBJECTIVES: The purpose of this paper was to estimate the factors associated with the pediatric Emergency Department (ED) visits for the acute ambulatory care sensitive conditions (ACSC).

METHODS:

We conducted a retrospective cross-sectional analysis of ED visits for pediatric ACSC over the years 2016-2019. We used the Healthcare Cost and Utilization Project (HCUP) for Arizona, Florida, Kentucky, Maryland, Nebraska, New Jersey, North Carolina, Oregon, Rhode Island, Vermont, and Wisconsin. Main outcome measure was the binary indicator for visits for ACS acute conditions that include gastroenteritis and urinary tract infections. Logistic regression model was used to predict visits for ACSC based on patients’ demographic, insurance status, income, and rurality.

RESULTS:

Of over 21 million pediatric ED visits in the selected states from 2016 to 2019, almost 4% were for acute ACSC. Children ages 5-11 were 1.10 times more likely to visit ED when compared to ages 0-4. Girls were 2.29 (aOR:2.29; CI=2.27-2.30) more likely than boys to visit ED. Patients with Medicaid, other public insurance, or no insurance were more likely than privately insured to have ED, respectively (aOR:1.12; CI=1.10-1.13), (aOR:1.20; CI=1.19-1.21), and (aOR:1.10; CI=1.08-1.11). Likewise, Hispanic, Asian or Pacific Islander, and multiracial patients were also more likely to present for an ACS condition when compared to the White patients, respectively (aOR:1.37; CI= 1.36- 1.38), (aOR:1.14; CI=1.12-1.16), and (aOR:1.10; CI=1.09-1.12). When compared to large central metropolitan area, patients in non-core (rural) were more likely to have ED visits for an acute ACS condition (aOR:1.10; CI=1.09-1.12).

CONCLUSIONS:

Our findings showed that younger age patients, girls, publicly insured and uninsured patients, patients from rural and large fringe metro area, Hispanic, Asian or Pacific Islander, and multiracial patients, and patients from the lower household income are most at risk for ED visits for acute ACSC.