© 2001 Oxford University Press
Emergency Room Use Among a Foster Care Sample: The Influence of Placement History, Chronic Illness, Psychiatric Diagnosis, and Care Factors
The Center for Research in Prevention, The University of Washington–School of Social Work, Seattle (Almgren, Marcenko)
Contact author: Gunnar Almgren, Ph.D., Center for Research in Prevention, The University of Washington-School of Social Work, 4101 15th Ave. NE, Seattle, WA 98105-6299. E-mail: mukboy{at}u.washington.edu.
Despite the physical, mental, and social health risks of foster children, relatively little attention has been paid to how they interact with emergency medicine. To address the need for more empirical research on this topic, we tested whether demographic characteristics, chronic health conditions, psychiatric disorders, and placement factors predicted ER use among children in Washington State's foster care system in fiscal year 1999. Medicaid claim records and Child Welfare administrative records for 8,716 children were used to extract data on the dependent variables of interest. Contrary to findings with general pediatric samples, the results showed that psychiatric conditions were the strongest predictors of ER use, followed by some chronic health problems. Children diagnosed with personality disorders or depression were 9.5 and 5.4 times more likely to be seen in the ER than children without a psychiatric diagnosis. Possible explanations for these findings are explored and implications for the health care and child welfare systems are discussed.
KEY WORDS: foster care, emergency room, mental health, psychiatric diagnosis, chronic health
