We all want equitable, comprehensive, easily accessible, coordinated, high quality value-based cared for all our pediatric patients, but sometimes geography can get in the way, leading to disparities in health outcomes for our pediatric patients. Just what are the differences seen in rural children who require admission compared to non-rural children? Peltz et al. (peds.2015-3156) looked at a retrospective cohort of more than 600,000 admissions in one year at 41 children’s hospitals using the Pediatric Health Information System (PHIS) and used ZIP codes to separate rural from non-rural homes of these hospitalized patients. While only 12% of admissions to these 41 free-standing children’s hospitals came from rural areas, compared to non-rural patients, these children from rural areas had a much higher prevalence of complex chronic conditions and need for high tech care.
They also generated higher inpatient costs because of their complexity and had a higher rate of readmission. So what are the implications of the differences seen in this study between rural and non-rural hospitalized children and what can be done about it? Dr. David Grossman, vice chair of the United States Preventive Services Task Force and a health services researcher weighs in with an accompanying commentary (peds.2016-0323) that supplements the information shared in this study. No matter where your patients come from, if you are interested in doing what you can to reduce disparities in health care, this study and commentary are well worth your attention.
