Abstract
Objective
To examine the risk of any and specific potentially preventable hospitalizations (PPHs)
for adults with cerebral palsy (CP) or spina bifida (SB). We hypothesize that PPH
risk is greater among adults with CP/SB compared with the general population.
Patients and Methods
Using January 1, 2007, to December 31, 2017, national private administrative claims
data (OptumInsight) in the United States, we identified adults with CP/SB (n=10,617).
Adults without CP/SB were included as controls (n=1,443,716). To ensure a similar
proportion in basic demographics, we propensity-matched our controls with cases in
age and sex (n=10,617). Generalized estimating equation models were applied to examine
the risk of CP/SB on PPHs. All models were adjusted for age, sex, race/ethnicity,
health indicators, US Census Division data, and socioeconomic variables. Adjusted
odds ratios were compared within a 4-year follow-up.
Results
Adults with CP/SB had higher risk for any PPH (odds ratio [OR], 4.10; 95% CI, 2.31
to 7.31), and PPHs due to chronic obstructive pulmonary disease/asthma (OR, 1.85;
CI, 1.23 to 2.76), pneumonia (OR, 3.01; 95% CI, 2.06 to 4.39), and urinary tract infection
(OR, 6.48; 95% CI, 3.91 to 10.75). Cases and controls who had an annual wellness visit
had lower PPH risk (OR, 0.52; 95% CI, 0.41 to 0.67); similarly, adults with CP/SB
who had an annual wellness visit compared with adults with CP/SB who did not had lower
odds of PPH (OR, 0.75; 95% CI, 0.60 to 0.94).
Conclusion
Adults with pediatric-onset disabilities are at a greater risk for PPHs. Providing
better access to preventive care and health-promoting services, especially for respiratory
and urinary outcomes, may reduce PPH risk among this patient population.
Abbreviations and Acronyms:
AHRQ (Agency for Healthcare Research and Quality), COPD (chronic obstructive pulmonary disease), CP (cerebral palsy), ICD (International Classification of Diseases), OR (odds ratio), OT (occupational therapy), PPH (potentially preventable hospitalization), PT (physical therapy), SB (spina bifida), UTI (urinary tract infection)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 03, 2022
Footnotes
For editorial comment, see page 2186
Grant Support: This research was developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR #90RTHF0001-01-00).
Identification
Copyright
© 2022 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Health Care for Adults With Cerebral Palsy and Spina Bifida—Must It Be so Difficult?Mayo Clinic ProceedingsVol. 97Issue 12
- PreviewFor children with cerebral palsy and spina bifida (CP/SB), their complex medical needs are often coordinated through a medical home or multidisciplinary clinic setting. In these settings, a care team works to coordinate appointments, follow up on missed appointments, and facilitate communication with and between medical providers and patients. This care coordination is often done through many methods and contact points. Despite this, children with CP/SB may still have unexpected or potentially preventable hospitalizations (PPHs) for urinary tract infection (UTI), pneumonia, pressure wounds, and other illnesses.
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