Emergency Department Utilization by Children in Foster Care

Jee, Sandra H.; Antonucci, Toni C.; Aida, Masahiko; Szilagyi, Moira A.; Szilagyi, Peter G.

doi:10.1367/A04-068R.1

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Volume 5, Issue 2 , Pages 102-106, March 2005

Emergency Department Utilization by Children in Foster Care

Sandra H. Jee, MD, MPH
- Address correspondence to Sandra H. Jee, MD, MPH, 601 Elmwood Ave, Box 777, Rochester, NY 14642
Toni C. Antonucci, PhD
- From the Division of General Pediatrics and Strong Children Research Center (Drs Jee, M. Szilagyi, and P. Szilagyi), University of Rochester School of Medicine and Dentistry, Rochester, NY; the Institute for Social Research (Dr Antonucci and Mr Aida), University of Michigan, Ann Arbor, Mich; and the Department of Psychology (Dr Antonucci), University of Michigan, Ann Arbor, Mich
Masahiko Aida, MA
- From the Division of General Pediatrics and Strong Children Research Center (Drs Jee, M. Szilagyi, and P. Szilagyi), University of Rochester School of Medicine and Dentistry, Rochester, NY; the Institute for Social Research (Dr Antonucci and Mr Aida), University of Michigan, Ann Arbor, Mich; and the Department of Psychology (Dr Antonucci), University of Michigan, Ann Arbor, Mich
Moira A. Szilagyi, MD, PhD
- From the Division of General Pediatrics and Strong Children Research Center (Drs Jee, M. Szilagyi, and P. Szilagyi), University of Rochester School of Medicine and Dentistry, Rochester, NY; the Institute for Social Research (Dr Antonucci and Mr Aida), University of Michigan, Ann Arbor, Mich; and the Department of Psychology (Dr Antonucci), University of Michigan, Ann Arbor, Mich
Peter G. Szilagyi, MD, MPH
- From the Division of General Pediatrics and Strong Children Research Center (Drs Jee, M. Szilagyi, and P. Szilagyi), University of Rochester School of Medicine and Dentistry, Rochester, NY; the Institute for Social Research (Dr Antonucci and Mr Aida), University of Michigan, Ann Arbor, Mich; and the Department of Psychology (Dr Antonucci), University of Michigan, Ann Arbor, Mich

Received 23 April 2004; accepted 10 November 2004.

Objective.—To examine emergency department (ED) utilization of children in foster care using nationally representative data.

Methods.—Cross-sectional analysis of the National Survey of Child and Adolescent Well-Being, Wave 1, which provided data for children ages 1 to 14 years in foster care for 1 year between October 1999 and December 2000. We identified children as having used the ED based upon foster parent responses to the question, “In the last 12 months, has your child gone to an emergency room or urgent care center (UCC) for an illness or injury?” We examined child and family demographic variables that were associated with having used the ED.

Results.—The sample included 559 children in foster care. Thirty-one percent (95% confidence interval = 26%, 36%) of foster children had visited the ED or UCC in the past 12 months. Multivariate logistic regression analysis revealed that out of all children in foster care, children who had a chronic condition, children of younger age, and children with younger foster caregivers were significantly more likely to have used the ED.

Conclusion.—A sizeable proportion of children in foster care use the ED, and subgroups of these children have particularly high rates of ED use. An important component of providing a medical home for children in foster care should involve coordination of care around ED visits for this vulnerable group of children.

KEY WORDS: emergency department , foster care , health care utilization