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Potentially Preventable Hospitalizations Among Adults With Pediatric-Onset Disabilities

  • Elham Mahmoudi
    Correspondence
    Correspondence: Address to Elham Mahmoudi, PhD, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd, Building 14, Room G234, Ann Arbor, MI 48109 USA.
    Affiliations
    Department of Family Medicine, Michigan Medicine, University of Michigan

    Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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  • Paul Lin
    Affiliations
    Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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  • Anam Khan
    Affiliations
    University of Michigan School of Public Health, University of Michigan, Ann Arbor, MI, USA

    Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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  • Neil Kamdar
    Affiliations
    Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Department of Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Department of Neurosurgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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  • Mark D. Peterson
    Affiliations
    Institute for Healthcare Policy and Innovation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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Published:November 03, 2022DOI:https://doi.org/10.1016/j.mayocp.2022.07.026

      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)
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