Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

David A. Paul, Abiy Agiro, Matthew Hoffman, Cynthia Denemark, Anthony Brazen, Michael Pollack, Christiana Boehmer, Deborah Ehrenthal

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


CONCLUSIONS: In this newborn Medicaid population, multiple maternal factors (including age, race, and mental health diagnoses) were associated with health care utilization in the 6 months after initial hospital discharge. Our data provide potential risk factors for targeted intervention and suggest that maternal factors should be considered in identifying a population at risk for rehospitalization and ED utilization.

RESULTS: The study cohort included 4112 infants; 452 (11.0%) were rehospitalized, and 1680 (41%) used the ED within 6 months of birth. Variables independently associated with inpatient rehospitalization included NICU admission (odds ratio [OR]: 1.7 [95% confidence interval (CI): 1.3-2.3]), maternal bipolar diagnosis (OR: 1.5 [95% CI: 1.1-2.2]), count of maternal prenatal hospital admissions (OR: 1.3 [95% CI: 1.1-1.5]), and count of maternal ED visits (OR: 1.08 [95% CI: 1.04-1.1]). Black race (incident rate ratio [IRR]: 1.2 [95% CI: 1.1-1.3]), fall birth (IRR: 1.2 [95% CI: 1.01-1.3]), count of maternal ED visits (IRR: 1.1 [95% CI: 1.09-1.12]), number of maternal medications (IRR: 1.02 [95% CI: 1.01-1.03]), and maternal age (IRR: 0.97 [95% CI: 0.96-0.98]) were associated with ED utilization.

BACKGROUND AND OBJECTIVE: In the first year of life, the rate of rehospitalization for infants has been shown to be between 4.4% and 9.5%. Reducing avoidable health care utilization is a population health priority. The goal of this study was to identify maternal and infant factors associated with rehospitalization and emergency department (ED) utilization in a cohort of newborn Medicaid recipients.

METHODS: A longitudinal database was created by linking mother-infant dyads giving birth at a regional perinatal referral center with Delaware state Medicaid data. Multivariable logistic regression and negative binomial regression were used to examine inpatient hospitalization and ED utilization within 6 months after birth.

Original languageEnglish (US)
Pages (from-to)587-594
Number of pages8
JournalHospital Pediatrics
Issue number10
StatePublished - Oct 1 2016

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics


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