The relationship between immigrant status and pediatric emergency department return visits.
CPS ePoster Library. Saunders N. 06/25/15; 99224; 163
Dr. Natasha Saunders
Dr. Natasha Saunders
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Abstract
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Background: Pre- and post-migration exposures are unique to pediatric immigrants and may affect healthcare access and quality. Children are high users of emergency departments (ED's). ED revisits may be a marker of access to and quality of healthcare for urgent problems. Interactions with the healthcare system for immigrant children may be hindered by differences in language or culture potentially leading to more frequent ED revisits compared with non-immigrant children.



Objective: To test whether being a pediatric immigrant increases the odds of unscheduled 7-day revisits to the ED compared with non-immigrant children living in urban Ontario and to test whether being from certain subgroups of immigrants increases the odds of ED revisits. These subgroups include immigrant class, native tongue upon landing in Canada, and region of origin.



Design/Methods: This was a retrospective population-based cohort study of all immigrant and non-immigrant children, living in urban Ontario, who visited an ED between April 2003 and March 2010 (n = 3322901). Multiple linked administrative health and demographic datasets were used to measure demographic variables, immigration information, ED visits and revisits, visit acuity and disposition, and hospital related data. The relationships between immigration status, immigration sub-groups and 7-day ED revisits were modeled using logistic regression models.



Results: Being a recent immigrant was associated with a significantly higher odds of ED revisit compared with non-immigrants (odds ratio 1.07; 95% CI 1.05-1.09). When biologically and clinically important covariates related to the patient, visit, and hospital were included in the adjusted model, the observed relationship between exposure groups disappeared. Within the immigrant group, the odds of revisit was not different between immigrant classes but immigrants who did not speak English or French as their native tongue had a higher odds of revisiting the ED after adjusting for socio-demographic and hospital characteristics (adjusted odds ratio 1.05; 95% CI 1.01-1.09). Differences were not observed based on region of origin.



Conclusions: Immigration status was not associated with increased ED revisits but having a native tongue other than English or French was associated with increased ED revisits. These findings are relevant for improving translation services in Ontario EDs and highlight the need for further research and understanding of pediatric immigrant health systems interactions.
Background: Pre- and post-migration exposures are unique to pediatric immigrants and may affect healthcare access and quality. Children are high users of emergency departments (ED's). ED revisits may be a marker of access to and quality of healthcare for urgent problems. Interactions with the healthcare system for immigrant children may be hindered by differences in language or culture potentially leading to more frequent ED revisits compared with non-immigrant children.



Objective: To test whether being a pediatric immigrant increases the odds of unscheduled 7-day revisits to the ED compared with non-immigrant children living in urban Ontario and to test whether being from certain subgroups of immigrants increases the odds of ED revisits. These subgroups include immigrant class, native tongue upon landing in Canada, and region of origin.



Design/Methods: This was a retrospective population-based cohort study of all immigrant and non-immigrant children, living in urban Ontario, who visited an ED between April 2003 and March 2010 (n = 3322901). Multiple linked administrative health and demographic datasets were used to measure demographic variables, immigration information, ED visits and revisits, visit acuity and disposition, and hospital related data. The relationships between immigration status, immigration sub-groups and 7-day ED revisits were modeled using logistic regression models.



Results: Being a recent immigrant was associated with a significantly higher odds of ED revisit compared with non-immigrants (odds ratio 1.07; 95% CI 1.05-1.09). When biologically and clinically important covariates related to the patient, visit, and hospital were included in the adjusted model, the observed relationship between exposure groups disappeared. Within the immigrant group, the odds of revisit was not different between immigrant classes but immigrants who did not speak English or French as their native tongue had a higher odds of revisiting the ED after adjusting for socio-demographic and hospital characteristics (adjusted odds ratio 1.05; 95% CI 1.01-1.09). Differences were not observed based on region of origin.



Conclusions: Immigration status was not associated with increased ED revisits but having a native tongue other than English or French was associated with increased ED revisits. These findings are relevant for improving translation services in Ontario EDs and highlight the need for further research and understanding of pediatric immigrant health systems interactions.
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