TY - JOUR
T1 - Interactive association of chronic illness and food insecurity with emergency department utilization among school-age children in the United States
T2 - A cross-sectional study
AU - Ghani, Farheen
AU - Wang, Hao
AU - Manning, Sydney E.
AU - Sambamoorthi, Usha
N1 - Funding Information:
The project described was supported in part by the National Institutes of Health (NIH) Agreement No. 1OT2OD032581‐01 (Usha Sambamoorthi), NIH/1OT2HL158258‐01 (Usha Sambamoorthi), and the National Institute on Minority Health and Health Disparities through the Texas Center for Health Disparities (NIMHD), 5U54MD006882‐10 (Hao Wang and Usha Sambamoorthi). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.
PY - 2023/2
Y1 - 2023/2
N2 - Background and Aims: Food insecurity combined with chronic disease conditions is a risk factor for Emergency Department (ED) utilization, an indicator of poor quality of care. However, such an association is not certain among school-age children with chronic conditions. Therefore, we aim to determine the association of food insecurity, chronic conditions, and ED utilization among school-age children in the United States. Methods: We analyzed the data from the 2017 Medical expenditure panel survey (MEPS) among children aged 6–17 years (N = 5518). MEPS data was released electronically by the Agency for Healthcare Research and Quality (AHRQ). We identified four groups of school-age children based on the presence of food security and chronic conditions: 1) with food insecurity and chronic conditions; 2) no food insecurity and chronic conditions; 3) with food insecurity and no chronic conditions; and 4) no food insecurity and no chronic conditions. We compared ED utilization among these four groups using incidence rate ratios (IRR) after adjusting children's age, sex, race and ethnicity, household income, insurance coverage, obesity, and geographic region using count data model, specifically multivariable Poison regression. We used SAS 9.4 and STATA 14.2 for all the data analyses. Results: There were unweighted 5518 school-age children who represented weighted 50,479,419 school-age children in the final analysis. Overall, 6.0% had food insecurity with chronic conditions. These children had higher ED utilization (19.7%) than the other three groups (13.3%, 8.8%, and 7.2%, p < 0.001). The adjusted IRR of ED utilization among school-age children with food insecurity and chronic conditions was 1.90 (95% confidence interval 1.20–3.01, p = 0.007) compared with those with food security and chronic conditions. Conclusion: One in 16 school-age children has both food insecurity and chronic conditions. Food insecurity was positively associated with frequent ED visits in the presence of chronic conditions. Therefore, addressing food insecurity may reduce the risk of ED visits.
AB - Background and Aims: Food insecurity combined with chronic disease conditions is a risk factor for Emergency Department (ED) utilization, an indicator of poor quality of care. However, such an association is not certain among school-age children with chronic conditions. Therefore, we aim to determine the association of food insecurity, chronic conditions, and ED utilization among school-age children in the United States. Methods: We analyzed the data from the 2017 Medical expenditure panel survey (MEPS) among children aged 6–17 years (N = 5518). MEPS data was released electronically by the Agency for Healthcare Research and Quality (AHRQ). We identified four groups of school-age children based on the presence of food security and chronic conditions: 1) with food insecurity and chronic conditions; 2) no food insecurity and chronic conditions; 3) with food insecurity and no chronic conditions; and 4) no food insecurity and no chronic conditions. We compared ED utilization among these four groups using incidence rate ratios (IRR) after adjusting children's age, sex, race and ethnicity, household income, insurance coverage, obesity, and geographic region using count data model, specifically multivariable Poison regression. We used SAS 9.4 and STATA 14.2 for all the data analyses. Results: There were unweighted 5518 school-age children who represented weighted 50,479,419 school-age children in the final analysis. Overall, 6.0% had food insecurity with chronic conditions. These children had higher ED utilization (19.7%) than the other three groups (13.3%, 8.8%, and 7.2%, p < 0.001). The adjusted IRR of ED utilization among school-age children with food insecurity and chronic conditions was 1.90 (95% confidence interval 1.20–3.01, p = 0.007) compared with those with food security and chronic conditions. Conclusion: One in 16 school-age children has both food insecurity and chronic conditions. Food insecurity was positively associated with frequent ED visits in the presence of chronic conditions. Therefore, addressing food insecurity may reduce the risk of ED visits.
KW - ED utilization
KW - MEPS
KW - chronic conditions
KW - food insecurity
KW - school-age population
UR - http://www.scopus.com/inward/record.url?scp=85149212709&partnerID=8YFLogxK
U2 - 10.1002/hsr2.1123
DO - 10.1002/hsr2.1123
M3 - Article
AN - SCOPUS:85149212709
SN - 2398-8835
VL - 6
JO - Health Science Reports
JF - Health Science Reports
IS - 2
M1 - e1123
ER -