Children who need hospitalization for various common respiratory conditions usually live in inner-city neighborhoods with less than optimal socioeconomic conditions, according to a recent study from the Cincinnati Children’s Hospital Medical Center whose researchers have assessed data and hospitalization records. The study was recently published in JAMA Pediatrics.
Researchers believe that if they can manage to identify these geographical areas, the data can be used as a vital sign, helping doctors and hospitals to better predict which children are exposed to higher risk of hospitalization and to intervene at much lower cost through population- and patient-level management of these acute heath conditions.
“The 20 percent of those most hospitalized with bronchiolitis had a hospitalization rate six times that of the 20 percent least hospitalized,” noted Andrew Beck who is the study’s lead author and a pediatrician at Cincinnati Children’s. The 20 percent of those that are among the most hospitalized because of pneumonia had a hospitalization rate equal to 11 times that of the 20 percent among the least hospitalized.
“These inequalities were associated with underlying differences in socioeconomic measures and were clustered geographically, with hospitalization hot spots in the inner city and cold spots in outlying suburbs,” said Todd Florin, co-lead author and pediatrician at Cincinnati Children’s. “This has substantial clinical and public health implications, suggesting small areas that could be targets for prevention and cost containment.”
The study took place after the 2013 Cincinnati Children’s study of asthma hospitalization showed that rates changed 18-fold across local neighborhoods. Researchers found that in the asthma study the neighborhoods often overlapped those in the new JAMA Pediatrics study, which calculated bronchiolitis and pneumonia hospitalization rates for Hamilton County, OH, as well for each of the 222 census tracts in the county.
The study included children hospitalized because of bronchiolitis or pneumonia at Cincinnati Children’s in the period of 2010 to 2013. Those hospitalized in Hamilton County are admitted to Cincinnati Children’s: bronchiolitis younger than 2, and pneumonia younger than 18.
“Most of the inner city is a hot spot for bronchiolitis and pneumonia, including the neighborhoods of Price Hill, Over-the-Rhine, Fairmount, Avondale and Evanston. This is similar to what we found for asthma,” concluded Beck.