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Background <p>The Child Opportunity Index (COI) is a measure of neighborhood conditions associated with healthy child development. Inguinal hernia repair (IHR) is a common pediatric procedure. We sought to evaluate the association between COI and complicated inguinal hernia (IH), incarcerated or strangulated IH, among children with employer-based insurance coverage.</p> Methods <p>We performed a retrospective cohort study of children who underwent IHR in the IBM Watson Health MarketScan<sup>®</sup> Research Database from 2015 to 2019. Claims data were merged with the COI at the metropolitan statistical area (MSA) level. We performed a multivariate regression analysis to determine the association between COI and complicated IH.</p> Results <p>A total of 12,084 eligible pediatric patients were identified, of which 3.7%(<i>n</i> = 408) had IH. Children with complicated IH were younger than those with uncomplicated IH (2 vs. 3&#xa0;years; <i>p</i> = 0.0016). There were no children from very low COI neighborhoods. There was no difference in COI between uncomplicated and complicated IH: (Low- 13.5% vs. 17.2%: Moderate- 67.3% vs. 63.5%; High- 19.2% vs. 19.4%; <i>p</i> = 0.19). Age (aOR: 0.967; 95% CI: 0.95–0.99), but not COI, was independently associated with decreased odds of complicated IH.</p> Conclusion <p>Neighborhood-level disadvantage, as measured by COI 2.0, was not an independent predictor of complicated IH among children with employer-based insurance coverage.</p> Level of evidence <p>II.</p>

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Neighborhood child opportunity and its association with complicated inguinal hernia in children: an analysis of a national insurance claims-based database

  • 期刊论文

  • 发表日期：

    2025年3月6日

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  • Theresa Ann Dickerson,
  • Ben Bodek,
  • Laritza Diaz,
  • Chris B. Agala,
  • Michael R. Phillips,
  • Sean E. McLean,
  • Adesola C. Akinkuotu

摘要

Background

The Child Opportunity Index (COI) is a measure of neighborhood conditions associated with healthy child development. Inguinal hernia repair (IHR) is a common pediatric procedure. We sought to evaluate the association between COI and complicated inguinal hernia (IH), incarcerated or strangulated IH, among children with employer-based insurance coverage.

Methods

We performed a retrospective cohort study of children who underwent IHR in the IBM Watson Health MarketScan® Research Database from 2015 to 2019. Claims data were merged with the COI at the metropolitan statistical area (MSA) level. We performed a multivariate regression analysis to determine the association between COI and complicated IH.

Results

A total of 12,084 eligible pediatric patients were identified, of which 3.7%(n = 408) had IH. Children with complicated IH were younger than those with uncomplicated IH (2 vs. 3 years; p = 0.0016). There were no children from very low COI neighborhoods. There was no difference in COI between uncomplicated and complicated IH: (Low- 13.5% vs. 17.2%: Moderate- 67.3% vs. 63.5%; High- 19.2% vs. 19.4%; p = 0.19). Age (aOR: 0.967; 95% CI: 0.95–0.99), but not COI, was independently associated with decreased odds of complicated IH.

Conclusion

Neighborhood-level disadvantage, as measured by COI 2.0, was not an independent predictor of complicated IH among children with employer-based insurance coverage.

Level of evidence

II.