WIP 16 - Association of Social Drivers of Health with Hospitalizations for Pediatric Asthma: An Investigation to Identify Effective Geomarkers of Children at Risk for Critical Asthma

Amy E. Hanson, Indiana University School of Medicine, Indianapolis, IN, United States; Samuel Ennett, ICF, Indianapolis, IN, United States; Colin M. Rogerson, Indiana University, Indianapolis, IN, United States

Background: Asthma is one of the most common reasons children present to the ED. Existing literature highlights various social factors associated with asthma diagnosis and outcomes at ZIP code level. One neighborhood-level analysis identified geographic hotspots (from which children with asthma were more likely to present in exacerbation) at census tract level, highlighting the critical role of social contexts. Further investigation of underlying SDoH at this more granular level (i.e. census tract) is essential for targeting interventions and resources effectively.

Objective: 1. Determine influence of specific SDoH on frequency of, and escalation of care for, pediatric patients presenting to Indiana EDs with acute/critical asthma.
2. Determine which publicly available composite predictive measure of socioeconomic status most closely correlates with pediatric acute/critical asthma patients’ hospital admission rates, peak respiratory support requirements, and ICU/hospital LOS.

Design/Methods: Retrospective cohort study in patients ages 2 to 18 years (using Indiana Network for Patient Care registry) diagnosed with acute (admitted to medical/surgical floor) or critical (admitted to ICU) asthma over three years to describe SDoH and potential healthcare utilization/outcome disparities. We hypothesize that publicly-available indices including higher area deprivation index, low income low access rank, higher (correlates with poorer) air quality index, linguistic isolation, lower childhood opportunity index, and higher social vulnerability index, will be associated with increased emergency room presentations and higher hospital/ICU admission rates.

IRB approval obtained (#23998). Regenstrief Research Institute feasibility inquiry estimates N=5,435. Data pull in progress, expected completion in ~2 weeks. Analysis plan: bivariate analysis of risk factors linked to emergency department disposition (i.e. discharge vs. admission, then floor vs. PICU) using Wilcoxon rank sum tests and Pearson X2 test as appropriate; SDoH measures and clinical variables evaluated via logistic regression analyses.