Abstract
Background
The objective was to examine the relationship between healthcare resource utilization patterns in tobacco smoke-exposed children (TSE group) compared with unexposed children (non-TSE group).
Methods
We matched 380 children in the TSE group with 1140 children in the non-TSE group based on child age, sex, race, and ethnicity using propensity scores. Healthcare resource utilization variables included respiratory-related procedures, diagnostic testing, disposition, and medications. Logistic and linear regression models were built.
Results
Child mean age was 4.9 (SD = 0.1) years, 50.5% were female, 55.5% black, and 73.2% had public insurance/self-pay. Compared to the non-TSE group, the TSE group was at increased odds to have the following performed/obtained: nasal bulb suctioning, infectious diagnostic tests, laboratory tests, and radiologic tests. The TSE group was more likely to be admitted to the hospital, and more likely to receive steroids and intravenous fluids during their visit. Among asthmatics, the TSE group was more likely to receive steroids, albuterol, or ipratropium alone, or a combination of all three medications during their visit, and be prescribed albuterol alone or steroids and albuterol.
Conclusion
Tobacco smoke-exposed children are more likely to have higher resource utilization patterns, highlighting the importance of screening and providing TSE prevention and remediation interventions.
Impact
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Tobacco smoke exposure may affect the healthcare resource utilization patterns of children.
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Evidence is lacking concerning these associations among the highly vulnerable pediatric emergency department patient population.
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This study examined the association between tobacco smoke exposure and healthcare resource utilization patterns among pediatric emergency department patients.
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Tobacco smoke exposure increased the risk of pediatric patients having respiratory-related procedures, respiratory-related and non-respiratory-related testing, medications administered during the pediatric emergency department visit, and medications prescribed for home administration.
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Tobacco smoke-exposed patients were more likely to be admitted to the hospital compared to unexposed patients.
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Acknowledgements
This work was funded by the National Institute on Drug Abuse (NIH Grant Number K01DA044313), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH Grant Number R01HD083354), and National Cancer Institute (NIH Grant Number R21CA184337).
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Merianos, A.L., Jandarov, R.A., Gordon, J.S. et al. Child tobacco smoke exposure and healthcare resource utilization patterns. Pediatr Res 88, 571–579 (2020). https://doi.org/10.1038/s41390-020-0997-0
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DOI: https://doi.org/10.1038/s41390-020-0997-0
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