Using State Administrative Data to Identify Social Complexity Risk Factors for Children

This study tests the feasibility of using an integrated state agency administrative database to identify social complexity risk factors and examined their relationship to emergency department (ED) use. A retrospective cohort study among children under age 18 years with state Medicaid insurance coverage was linked to child and parent administrative data to identify a set of social complexity risk factors, such as poverty and parent mental illness, that have either a known or hypothesized association with suboptimal health care use. Nine risk factors were associated with a higher rate of ED use. The rate increased as the number of risk factors increased from 0 to 5 or more, reaching about twice the rate when 5 or more risk factors were present in children aged younger than 5 years and in children aged 5 to 17 years.