Hospital and emergency department use by young low-income children

Background: Limited data are available concerning determinants of health ca re service usage by low-income young children. Objectives: To explore predictors of hospitalization and emergency departme nt (ED) use by young children of low income families by using the Aday and Andersen Access Framework. Methods: Low-income women (n = 474) with a child younger than 6 years compl eted a structured face-to-face interview at human service offices or Women, Infants, and Children (WIC) clinics in four central Ohio counties. Women w ere considered low-income if they or their child were Medicaid eligible or uninsured. Data were collected for both the mother and the index child on s ociodemographic status, health services use, health status, and access to c are. Results: Fifteen percent of the children had been hospitalized the previous year, and half had an ED visit. Hospitalization was significantly related to maternal hospitalization the previous year (OR = 2.5), child age younger than 1 year old (OR = 2.1) and more than two chronic conditions (OR = 2.2) . Maternal ED usage in the last year (OR = 2.2), Medicaid fee for service p lan (OR = 1.7), and rural residence (OR = 2.0) were predictive of ED use. Conclusions: Predisposing characteristics (maternal hospital/ED use) were p redictive of both hospitalization and ED use by the index child. Enabling c haracteristics (fee-for-service Medicaid plan, rurality) were only predicti ve of ED use, and need characteristics (child's health) were only predictiv e of hospitalization. Further research to explore linkages between maternal and child use of health care services as well as the effect of changes in health care access, managed care, and other innovations on hospitalization and ED use in young, low-income children is recommended.