Testingers at Cincinnati Children's Hospital Medical Center say an initiative that involved identifying "hot spots" for social needs among children living in neighborhoods with high rates of morbidity and poverty could be a potential model for health systems across the country.
Results of a new study published Tuesday in Health Affairs showed the medical center reduced the number of days children spent in the hospital by 20% for patients living in two low-income neighborhoods that were studied over a three-year period.
Study lead author Dr. Andrew Beck said the findings reflect a real opportunity for health systems to narrow health gaps between socio-economic classes.
"Disparities are a persistent problem that's been with us for generations and that's highly apparent within the current state of our communities," said Beck, an associate professor of pediatrics at the University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center.
A focus of the Cincinnati Children's approach involved using real-time electronic health data to identify "hot spots" throughout the city.
The study examined hospital use among 8,000 children between the base period of 2012 through 2015 and the intervention period from 2015 through 2018. Children's also employed teams focused on chronic disease management and worked with community partners to mitigate social needs such as unstable housing and hunger.
The study found that children spent 2,145 days in the hospital during the intervention period compared with 2,720 days during the period prior to the initiative. The number of total hospitalizations decreased during the study period from 1,344 to 1,041 during the initiative. The initiative was associated with an 18% decline in the average monthly inpatient bed-day rate within the two neighborhoods studied.
He said the initiative aimed to reduce hospital utilization regardless of the health condition with the exception of cancer in order to identify what were some of the more common social factors underpinning morbidity and disparity in poorer areas.
That is different from previous population health management interventions that have focused on improving outcomes of patients with a specific disease such as diabetes or asthma.
"I think there is relevance in thinking from a condition-specific standpoint," Beck said. "But at the same time when you focus too narrowly on a single condition, I think you miss out on what's common across all of them."
Beck said there are no immediate plans to expand the initiative into more communities. But he expects the program will be adopted in other communities as a part of Children's long-term population health strategy.