Predictors of emergency department utilization among children in vulnerable families

Colin Flood*, Karen Sheehan, Marie Crandall

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objective: The aim of this study was to identify factors associated with high ED utilization among children in vulnerable families. Methods: The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5000 vulnerable children. Data from the 9-year follow-up survey were used in this analysis. Bivariate and multivariate logistic regression analyses were performed to identify correlates with high ED utilization (≥4 visits per year). Results: 2631 children were included in the analysis. In a multivariate model controlling for the child’s sex, race, household income, and insurance status, 4 variables were significant predictors of ED utilization: history of hospitalization within the last year (odds ratio [OR], 15.97; 95% confidence interval [CI], 6.64–38.41; P < 0.001), diagnosis of asthma (OR, 2.53; 95% CI, 1.17–5.44; P = 0.02), number of child’s office/clinic visits within the last year (OR, 1.22; 95% CI, 1.12–1.33; P < 0.001), and number of primary caregiver ED visits within last year (OR, 1.15; 95% CI, 1.03–1.28; P = 0.01). Conclusions: History of hospitalization, outpatient visits, primary caregiver ED utilization, and diagnosis of asthma independently predict high ED utilization by 9-year-old children in fragile families. Augmented continuity of care, disease management, and caregiver education may reduce high ED utilization in this population.

Original languageEnglish (US)
Pages (from-to)765-769
Number of pages5
JournalPediatric emergency care
Issue number12
StatePublished - Jan 1 2017


  • Child Wellbeing Study
  • Fragile Families
  • Preventable visits
  • Vulnerable families

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine


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