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Lack of Association of Household Income and Acute Gastroenteritis Disease Severity in Young Children: A Cohort Study.
Chun, Thomas H; Schnadower, David; Casper, T Charles; Sapién, Robert; Tarr, Phillip I; O'Connell, Karen; Roskind, Cindy; Rogers, Alexander; Bhatt, Seema; Mahajan, Prashant; Vance, Cheryl; Olsen, Cody S; Powell, Elizabeth C; Freedman, Stephen B.
Affiliation
  • Chun TH; Department of Emergency Medicine and Pediatrics, Hasbro Children's Hospital, Brown University (TH Chun), Providence, RI.
  • Schnadower D; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine (D Schnadower), Cincinnati, Ohio.
  • Casper TC; Department of Pediatrics, University of Utah (TC Casper), Salt Lake City, Utah.
  • Sapién R; Department of Emergency Medicine, University of New Mexico Health Sciences Center (R Sapién), Albuquerque, NM.
  • Tarr PI; Division of Gastroenterology, Hepatology, & Nutrition, Department of Pediatrics, Washington University in St. Louis School of Medicine (PI Tarr), St. Louis, Mo.
  • O'Connell K; Division of Emergency Medicine, Department of Pediatrics, Children's National Hospital, The George Washington School of Medicine and Health Sciences (K O'Connell), Washington, DC.
  • Roskind C; Department of Emergency Medicine, Columbia University College of Physicians & Surgeons (C Roskind), New York, NY.
  • Rogers A; Departments of Emergency Medicine and Pediatrics, University of Michigan (A Rogers and P Mahajan), Ann Arbor, Mich.
  • Bhatt S; Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine (S Bhatt), Cincinnati, Ohio.
  • Mahajan P; Departments of Emergency Medicine and Pediatrics, University of Michigan (A Rogers and P Mahajan), Ann Arbor, Mich; Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Michigan Wayne State University (P Mahajan), Detroit, Mich.
  • Vance C; Departments of Pediatrics and Emergency Medicine, University of California, Davis, School of Medicine (C Vance), Sacramento, Calif.
  • Olsen CS; Department of Pediatrics, University of Utah (CS Olsen), Salt Lake City, Utah.
  • Powell EC; Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine (EC Powell), Chicago, Ill.
  • Freedman SB; Divisions of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary (SB Freedman), Calgary, Alberta, Canada.. Electronic addres
Acad Pediatr ; 22(4): 581-591, 2022.
Article in En | MEDLINE | ID: mdl-34274521
OBJECTIVE: To determine if low household income is associated with disease severity following emergency department (ED) discharge in children with acute gastroenteritis (AGE). METHODS: We conducted a secondary analysis employing data collected in 10 US-based tertiary-care, pediatric EDs between 2014 and 2017. Participants were aged 3 to 48 months and presented for care due to AGE. Income status was defined based on 1) home ZIP Code median annual home income and 2) percentage of home ZIP Code households below the poverty threshold. The primary outcome was moderate-to-severe AGE, defined by a post-ED visit Modified Vesikari Scale (MVS) score ≥9. Secondary outcomes included in-person revisits, revisits with intravenous rehydration, hospitalization, and etiologic pathogens. RESULTS: About 943 (97%) participants with a median age of 17 months (interquartile range 10, 28) completed follow-up. Post-ED visit MVS scores were lower for the lowest household income group (adjusted: -0.60; 95% confidence interval [CI]: -1.13, -0.07). Odds of experiencing an MVS score ≥9 did not differ between groups (adjusted odds ratio: 0.91; 95% CI: 0.54, 1.52). No difference in the post-ED visit MVS score or the proportion of participants with scores ≥9 was observed using the national poverty threshold definition. For both income definitions, there were no differences in terms of revisits following discharge, hospitalizations, and intravenous rehydration. Bacterial enteropathogens were more commonly identified in the lowest socioeconomic group using both definitions. CONCLUSIONS: Lower household income was not associated with increased disease severity or resource use. Economic disparities do not appear to result in differences in the disease course of children with AGE seeking ED care.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Gastroenteritis Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Child / Child, preschool / Humans / Infant Language: En Journal: Acad Pediatr Year: 2022 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Gastroenteritis Type of study: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Child / Child, preschool / Humans / Infant Language: En Journal: Acad Pediatr Year: 2022 Document type: Article