TABLE 3

Multivariate Analysis of Children Experiencing a Low-Resource ED Visit

OverallaNo. of ED Visits Within a 365-Day Period
123≥4
Chronic condition
 None2.9 (2.8–2.9)2.8 (2.7–2.9)2.5 (2.5–2.6)2.6 (2.6–2.7)3.1 (3.0–3.1)
 Non-CCCb1.9 (1.9–1.9)1.8 (1.7–1.9)1.7 (1.6–1.7)1.7 (1.7–1.8)2.0 (2.0–2.0)
 CCCcRefRefRefRefRef
Age
 <1 year3.0 (3.0–3.0)2.4 (2.4–2.4)3.0 (3.0–3.1)3.4 (3.3–3.5)3.8 (3.7–3.9)
 1–4 years2.4 (2.4–2.5)2.1 (2.1–2.2)2.5 (2.5–2.6)2.7 (2.7–2.8)2.9 (2.9–3.0)
 5–9 years1.7 (1.6–1.7)1.5 (1.5–1.5)1.7 (1.7–1.8)1.8 (1.8–1.9)1.8 (1.8–1.9)
 10–14 years1.2 (1.2–1.2)1.1 (1.1–1.1)1.3 (1.2–1.3)1.3 (1.3–1.3)1.3 (1.3–1.3)
 ≥15 yearsRefRefRefRefRef
Race/ethnicity
 Non-Hispanic black1.3 (1.3–1.3)1.4 (1.4–1.4)1.4 (1.3–1.4)1.3 (1.3–1.3)1.2 (1.2–1.2)
 Hispanic1.2 (1.2–1.2)1.3 (1.3–1.3)1.2 (1.2–1.3)1.2 (1.2–1.2)1.2 (1.1–1.2)
 Asian1.0 (1.0–1.0)1.0 (1.0–1.1)1.1 (1.0–1.1)1.0 (1.0–1.1)1.0 (0.9–1.0)
 Other1.2 (1.2–1.2)1.2 (1.2–1.3)1.2 (1.1–1.2)1.2 (1.1–1.2)1.1 (1.1–1.1)
 Non-Hispanic whiteRefRefRefRefRef
Public insurance1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)
Urban (versus rural)1.2 (1.2–1.2)1.2 (1.2–1.2)1.2 (1.1–1.2)1.2 (1.1–1.2)1.3 (1.2–1.3)
Distance from hospitald
 <5 miles1.4 (1.4–1.4)1.4 (1.4–1.5)1.3 (1.3–1.4)1.4 (1.3–1.4)1.4 (1.3–1.4)
 5–10 miles1.3 (1.3–1.4)1.4 (1.3–1.4)1.3 (1.3–1.3)1.3 (1.3–1.4)1.3 (1.3–1.4)
 11–20 miles1.2 (1.2–1.2)1.2 (1.1–1.2)1.2 (1.1–1.2)1.2 (1.2–1.2)1.2 (1.2–1.2)
 >20 milesRefRefRefRefRef
Primary care physician densitye
 Highest quartile (≥78.8)1.1 (1.0–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)
 Third quartile (68.0–78.7)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.2)1.2 (1.2–1.2)
 Second quartile (57.2–67.9)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.1)1.1 (1.1–1.2)1.1 (1.1–1.2)
 Lowest quartile (<57.2)RefRefRefRefRef
Time of day
 8:00 am–3:59 pm1.5 (1.5–1.5)1.4 (1.4–1.5)1.5 (1.4–1.5)1.5 (1.5–1.5)1.6 (1.5–1.6)
 4:00 pm–11:59 pm1.4 (1.4–1.4)1.4 (1.3–1.4)1.4 (1.4–1.4)1.5 (1.4–1.5)1.5 (1.5–1.5)
 Midnight–7:59 amRefRefRefRefRef
Day of the week
 WeekdayRefRefRefRefRef
 Weekend1.0 (1.0–1.0)1.1 (1.0–1.1)1.0 (1.0–1.0)1.0 (1.0–1.0)1.0 (1.0–1.0)
Model C-statistic0.660.640.640.650.68
  • Data are presented as ORs (95% CIs). A low-resource ED visit is one not associated with admission, laboratory testing, radiographic testing, or medication administration (aside from acetaminophen or ibuprofen). Ref, reference.

  • a Model additionally adjusted for number of ED visits.

  • b These children had a chronic condition, identified with the Agency for Healthcare Research and Quality’s Chronic Condition Indicator system, but did not have a CCC, identified with Feudtner’s diagnosis list.23

  • c These children had a CCC identified with Feudtner’s diagnosis list.

  • d Calculated with the 5-digit zip code of residence in relation to hospital address.

  • e Primary care physician density is the number of primary care physicians per 100 000 residents based on zip code of residence.