Pediatric Trauma Society

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Investigation Of The Equity Of Emergency Department Use For Childhood Injuries: An Analysis Of Upstate SC Children
Kerry K Sease1, Sarah F Griffin2, Jacqueline E Forrester1, Christopher M Wilson2
1Greenville Health System, Greenville, SC;2Clemson University, Clemson, SC

Background (issue): It is well known that certain individual-level socioeconomic characteristics contribute to child injury rate variance. The purpose of this study was to investigate whether these same characteristics contribute to injury rate variance at the community level.
Methods: Demographic and injury data for children aged 19 years and younger who received emergency department (ED) services from a health system between January 1, 2012 and October 31, 2015 were extracted from an electronic medical record system and retrospectively reviewed. Four categories of injury were examined: bicycles, falls, motor vehicle collisions (MVC) and violent acts. Frequencies and rates of injury variance were analyzed at the individual level and by zip code grouping. Multi-variable linear regression was used to determine whether correlation exists between geographic socioeconomic characteristics and injury rate variance at the community level.
Findings: 1,432 ED visits were identified. Of these, injuries from falls (36%) and MVC (35%) made up the majority of the visits. Injury rates were highest among minority children, children from high poverty areas, children from areas with high levels of uninsured residents, and rural areas. Community-level factors associated with higher child injury rates included percent of the population that are rural and percent uninsured. Factors associated with lower child injury rates included child poverty and percent of the population that are minority.
Conclusions (implications for practice): Child injury rates can cluster along different individual and community-level socioeconomic characteristics, suggesting cultural, community, and social factors may play a role in injury rates. Additional research on community-level risk factors is required to inform effective injury prevention programming.


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