Predicting the preventable: Social drivers of health on pediatric readmissions and emergency department visits.

OBJECTIVE

This study aimed to examine the extent to which pediatric emergency department visits and admissions are preventable and whether caregiver-reported social factors predict future preventable visits.

METHOD: Caregivers of hospitalized children (N = 249) completed a predischarge survey regarding health care utilization and social drivers of health (e.g., adverse childhood experiences and experiences of racial discrimination). Chart reviews were conducted 365 days postdischarge to capture the presence and frequency of acute medical events (AMEs; i.e., readmissions and emergency department visits). Three methods of determining the preventability of AMEs were used to examine the relationship between preventable AMEs and medical status, demographic characteristics, and social drivers of health.

RESULTS

Of the youth who experienced an AME, over half (67%) experienced one or more events classified as "preventable" by at least one method. Statistically significant predictors associated with preventable events included age under 1 (OR = 4.17), complex/chronic medical status (OR = 3.03), other children in the home with health concerns (OR = 1.85), and the presence of a neurocognitive disorder (OR = 2.97). Higher caregiver education (incidence rate ratio [IRR] = 0.31) was related to fewer preventable events overall. Child mental health condition (IRR = 18.62), having a deceased caregiver (IRR = 4.35), and child experiences of racial or ethnic discrimination (IRR = 6.01) were related to more preventable readmissions.

CONCLUSION

A substantial number of AMEs may be preventable. Caregiver reports of social factors should be included in risk assessments to inform tailored interventions and discharge plans based on unique family characteristics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).