Frequent residential moves associated with increased potentially preventable hospitalizations

1. Children who moved 2 or more times within the first year of life had significantly increased risk of experiencing potentially preventable hospitalizations between the ages of 1 and 5 years.

2. Children whose families did not move in the first year of life showed decreased risk for potentially preventable hospitalizations over time.

Evidence Rating Level: 2 (Good)

Study Rundown: Frequent moving early in childhood has been associated with various adverse health outcomes, both independently and due to influences such as familial stress and low socioeconomic status. Frequent moving may prevent the establishment of physician-family relationships and consistent access to preventive care. This study is the first to consider the effects of increased residential moves on number of potentially preventable hospitalizations (PPH) that may have been curtailed with proper access to primary care. After adjusting for cofounders, this study found that children who experience at least 2 moves in the first year of life were at increased risk of higher PPH, especially in years 1 and 2 of life. Children that did not move in the first year of life had decreased risk of PPH over time. Given the results of this study, frequent residential moves may have lasting effects on the health of pediatric patients. As such, clinicians should consider increasing their own awareness of new patients or those whose families have moved frequently in the past, and adjust their practice accordingly. While this study highlights negative consequences of frequent moving, it is limited by the inability to completely control for subtle cofounders in the data set.

Click to read the study published today in Pediatrics

Relevant Reading: Childhood residential mobility and health in late adolescence and adulthood: findings from the West of Scotland 2007 study

Study Author, Hayley A. Hutchings, PhD, talks to 2 Minute Medicine: Swansea University Medical School, Patint and Population Health and Informatics Research, Swansea, United Kingdom

“Our research highlights that in order to prevent emergency admissions it is important for health professionals to consider social and environmental factors when assessing young children in the emergency room.  We have shown that frequently moving home may increase a child’s risk of emergency admission which could be a marker of a chaotic family life, and a possible indicator for additional social or healthcare support.”

In-Depth [retrospective cohort study]: This study included 237 842 children from the Wales Electronic Cohort for Children (WECC) database born, and living, in Wales, United Kingdom. Children were followed up to 5 years of age for PPH, which were identified via hospital ICD-10 codes. PPH included various acute, chronic, and vaccine-preventable conditions, such as influenza/pneumonia, dehydration/gastroenteritis, ear, nose, throat infections, convulsions/epilepsy, and injuries/poisonings. Of the total sample, 84.6% of children never moved in the first year of life, while 13.3% moved once, and 2.1% moved 2 or more times. Increasing moves in the first year of life was associated with increased frequency of all types of PPH up to the first 5 years of life (p ≤ .05). Once adjusted for cofounders, these results continued to be significant for ear, nose, and throat infections, convulsions/epilepsy, injuries, dehydration/gastroenteritis, influenza/pneumonia and dental conditions (p ≤ .05). Children with just 1 move in the first year had increased risk of PPH, though not as high as those experiencing at least 2 moves. Among children who did not move in the first year of life, 13.9% had at least 1 PPH between 1 and 5 years old, compared to 16.4% of children moving at least 2 times. After adjusting for cofounders, the risk of PPH increased by 45% for children with at least 2 moves in the first year of life compared to those with no moves (IRR 1.45, 95% CI 1.34-1.57).

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