Article

OBJECTIVE: To compare emergency room (ER) and inpatient hospital (IP) use rates
for persons with spina bifida (SB) to peers without SB, when transition from
pediatric to adult health care is likely to occur; and to analyze those ER and IP
rates by age, race, socioeconomic status, gender, and type of residential area.
DESIGN: A retrospective cohort study. SETTING: Secondary data analysis in South Carolina. PARTICIPANTS: We studied individuals who were between 15 and 24 years
old and enrolled in the State Health Plan (SHP) or state Medicaid during the
2000-2010 study period. METHODS: Individuals with SB were identified using ICD-9
billing codes (741.0, 741.9) in SHP, Medicaid, and hospital uniform billing (UB)
data. ER and IP encounters were identified using UB data. Multivariable
Generalized Estimating Equation (GEE) Poisson models were estimated to compare
rates of ER and IP use among the SB group to the comparison group. MAIN OUTCOME
MEASURES: Total ER rate and IP rate, in addition to cause-specific rates for
ambulatory care sensitive conditions (ACSC) and other condition categories.
RESULTS: We found higher rates of ER and IP use in persons with SB compared to
the control group. Among individuals with SB, young adults (those 20-24 years
old) had higher rates of ER use due to all ACSC (P = .023), other ACSC (P = .04),
and urinary tract infections (UTI; P = .002) compared to adolescents (those 15-19
years old). CONCLUSIONS: Young adulthood is associated with increased ER use
overall, as well as in specific condition categories (most notably UTI) in
individuals 15-24 years old with SB. This association may be indicative of
changing healthcare access as people with SB move from adolescent to adult health
care, and/or physiologic changes during the age range studied.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
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Langue : ANGLAIS