Study Finds Odds of Low-value Care Are Greater in Children From Neighborhoods With Higher Opportunity

A new study, “Childhood Opportunity Index and Low-Value Care in Children's Hospitals,” investigates the relationship between low-value care, defined as healthcare services where potential benefits don’t outweigh harms or costs, and a child’s neighborhood resources as measured by Childhood Opportunity Index, or COI. The childhood opportunity index is a composite measure comprised of 29 fields in the areas of education, health and environment, and social and economic conditions. The study, published in the October 2024 Pediatrics (published online Sept. 9), examined data from July 2021 through June 2022 representing care at 47 academic pediatric hospitals across 27 states and Washington, D.C. participating in the Pediatric Health Information System database. Prior studies have suggested a relationship between low-value care and some social health drivers. Researchers found the odds of low-value care increased overall as neighborhood opportunity increased. Few individual measures demonstrated a reverse trend (higher odds of low-value care among children with lesser opportunity). Despite higher likelihood of low-value care receipt in those with more opportunity, the overall volume of low-value care delivery was highest among children with low childhood opportunity index for many measures, owing to a higher number of hospital-based encounters for this population. The authors recommend broad de-implementation efforts to reduce low-value care, with special attention to measures with greater impact on children with lesser opportunity.

###

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.