Andrew Beck, MD.

Andrew Beck, MD

Inner-city children are at greater risk of needing hospitalization for common respiratory illnesses, say Cincinnati Children’s researchers.

They published their findings online July 20, 2015, in JAMA Pediatrics, after studying census tract data and hospitalization records.

Researchers believe that identifying hotspot geographic areas can help doctors predict which children are at greater risk of hospitalization and intervene, at a reduced cost, through patient- and population-level management of acute conditions.

The study, led by pediatrician Andrew Beck, MD, looked at children hospitalized for bronchiolitis or pneumonia at Cincinnati Children’s between 2010 and 2013. Those hospitalized with bronchiolitis were younger than 2, those with pneumonia younger than 18. Patients were identified using discharge diagnosis codes, then geocoded to their home census tract.

The findings showed great disparities based largely on where children lived.

“The most-hospitalized group with bronchiolitis had a hospitalization rate six times that of the least hospitalized,” says Beck. “Those most hospitalized with pneumonia had a hospitalization rate 11 times that of the least hospitalized.”

Todd Florin, MD, who co-authored the study with Beck, adds, “The inequalities were associated with underlying differences in socioeconomic measures and were clustered geographically, with hospitalization hot spots in the inner city and cold spots in outlying suburbs.”

Findings were similar to a 2013 Cincinnati Children’s study of asthma hospitalization demonstrating that rates varied 18-fold across local neighborhoods. The neighborhoods in the new JAMA Pediatrics study often overlapped those in the asthma study.

“This has substantial clinical and public health implications, suggesting small areas that could be targets for prevention and cost containment,” says Florin.

A map showing inner city hot spots.