Health Disparities
Predictors of Pediatric Respiratory Disease in New York State Erin Ryan Kulick* Erin Kulick Marina Oktapodas Feiler Jack McClamrock
Pediatric respiratory-related hospitalizations are disproportionally distributed across racial and ethnic populations in the US. Current research has mainly focused on smaller homogenous populations making the true burden of disease across diverse populations largely unknown. Statewide existing data was leveraged to examine the distribution and predictors of pediatric acute respiratory disease using data from the New York State (NYS) Department of Health Statewide Planning and Research Cooperative System (SPARCS). This administrative claim database contains 98% of all hospitalizations in NYS, allowing us to examine a diverse population regarding race, ethnicity, insurance status, and geography. The study sample included pediatric discharges in NYS from 2009-2017. Patient characteristics, diagnoses, treatments, and billing were collected for hospitalizations or ED visits. Diagnoses are established using ICD-9/10 codes at the first two diagnostic positions. The primary outcome was all-cause respiratory discharges. Distributions of sociodemographic characteristics were calculated as proportions for categorical variables. Differences in sociodemographic characteristics between overall and acute respiratory hospitalizations were tested using chi-squared tests. Log-binomial regression was modeled to identify sociodemographic predictors of respiratory hospitalizations.
Over 2.9 million acute respiratory hospitalizations among pediatric patients were identified (18% of all pediatric hospitalizations), with 91% being emergency department visits. The risk of a respiratory hospitalization was highest among those who were >1-5 years, Black race, and Hispanic or Multi-ethnic (Table 1). This descriptive study identified pediatric populations at high risk for acute respiratory hospitalizations using a highly representative sample and reducing selection bias. Next steps include consideration of environmental and structural determinants of health and individual respiratory outcomes.
