Presenter Status
Resident/Psychology Intern
Abstract Type
Research
Primary Mentor
Jessica Bettenhausen, MD
Start Date
9-5-2023 12:30 PM
End Date
9-5-2023 12:45 PM
Presentation Type
Abstract
Description
Background: At Children’s Mercy Hospital, greater than 1 in 5 hospitalized children are from rural areas. Rural families often travel long distances for hospitalization at free-standing children’s hospitals, a median of 70 miles according to recent work. Rural families are more likely than non-rural families to experience financial insecurity, and these baseline hardships may be intensified during hospitalization due to out-of-pocket costs, lost work, inability to meet family needs, and removal from social support. However, little is known about the differences in healthcare access and resulting burdens between rural and non-rural families.
Objectives/Goal: To describe differences in demographics, health care access, and clinical outcomes for rural children compared to their non-rural counterparts.
Methods/Design: This prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Children with medical complexity were excluded. We gathered demographic information and surveyed caregivers to quantify perceived access to high quality care, distance to primary care, and distance and mode of transport to the children’s hospital. Clinical information, including length of stay (LOS), severity (using the Hospital Resource Intensity Score for Kids, [H-RISK]), ICU admission, costs, and diagnoses (using the Clinical Classification Software) were extracted from the Pediatric Health Information System. Bivariate analyses, including Chi-square and Wilcoxon Rank Sum tests where appropriate, were used to determine statistically significant differences.
Results: 170 caregivers, 47.7% from rural areas were enrolled in the study (Table 1). A greater proportion of rural vs. non-rural caregivers were white (80.2% vs. 70.8%) and reported lower levels of income (56.8% vs. 33.7% with income of
Conclusions: Rural caregivers more commonly report poor health care access, which may predispose rural children to hospitalizations. In addition, higher utilization of air transport coupled with low incomes may create a disproportionate burden for rural families when children are hospitalized. Interventions aimed at improving access to high value care and decreasing avoidable hospitalizations for rural patients, such as telehealth consultations to ensure the need for hospitalization prior to admission, may help to decrease unnecessary hardships experienced by rural caregivers.
Included in
Higher Education and Teaching Commons, Medical Education Commons, Pediatrics Commons, Science and Mathematics Education Commons
Relationship between Rurality and Access to Care for Families of Hospitalized Children
Background: At Children’s Mercy Hospital, greater than 1 in 5 hospitalized children are from rural areas. Rural families often travel long distances for hospitalization at free-standing children’s hospitals, a median of 70 miles according to recent work. Rural families are more likely than non-rural families to experience financial insecurity, and these baseline hardships may be intensified during hospitalization due to out-of-pocket costs, lost work, inability to meet family needs, and removal from social support. However, little is known about the differences in healthcare access and resulting burdens between rural and non-rural families.
Objectives/Goal: To describe differences in demographics, health care access, and clinical outcomes for rural children compared to their non-rural counterparts.
Methods/Design: This prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Children with medical complexity were excluded. We gathered demographic information and surveyed caregivers to quantify perceived access to high quality care, distance to primary care, and distance and mode of transport to the children’s hospital. Clinical information, including length of stay (LOS), severity (using the Hospital Resource Intensity Score for Kids, [H-RISK]), ICU admission, costs, and diagnoses (using the Clinical Classification Software) were extracted from the Pediatric Health Information System. Bivariate analyses, including Chi-square and Wilcoxon Rank Sum tests where appropriate, were used to determine statistically significant differences.
Results: 170 caregivers, 47.7% from rural areas were enrolled in the study (Table 1). A greater proportion of rural vs. non-rural caregivers were white (80.2% vs. 70.8%) and reported lower levels of income (56.8% vs. 33.7% with income of
Conclusions: Rural caregivers more commonly report poor health care access, which may predispose rural children to hospitalizations. In addition, higher utilization of air transport coupled with low incomes may create a disproportionate burden for rural families when children are hospitalized. Interventions aimed at improving access to high value care and decreasing avoidable hospitalizations for rural patients, such as telehealth consultations to ensure the need for hospitalization prior to admission, may help to decrease unnecessary hardships experienced by rural caregivers.
