Receipt of needed care coordination and emergency department utilization among US children with chronic physical pain: a pooled analysis of the 2022-2024 National Survey of Children's Health.
- 1Pediatrics, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.
- 2State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
- 3School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Abstract
Background
Children with chronic physical pain often require complex, multidisciplinary services across medical, behavioral, and community systems. However, whether receipt of needed care coordination is associated with acute healthcare utilization and care access in this population remains poorly characterized.Methods
We conducted a pooled cross-sectional analysis of the 2022-2024 National Survey of Children's Health (NSCH). The analytic cohort included US children aged 6-17 years with caregiver-reported chronic physical pain who had an identified need for care coordination. The exposure was receipt of needed care coordination. The primary outcome was all-cause emergency department (ED) utilization (≥1 visit) in the prior 12 months. Survey-weighted multivariable logistic regression was used, with a minimally adjusted model (sociodemographic factors) and a fully adjusted model (additionally including insurance status, anxiety, depression, and functional difficulties) reported side by side.Results
Among 6,326 eligible children (representing an average of 878,491 children annually), weighted 12-month ED visit rates were 29.0% (95% CI, 25.4%-32.5%) for those who received needed care coordination versus 40.0% (95% CI, 36.4%-43.7%) for those who did not. In the minimally adjusted model, receipt of needed care coordination was associated with lower odds of ED utilization (adjusted OR [aOR] 0.61; 95% CI, 0.48-0.76; P < .001; n = 6,310). This association persisted in the fully adjusted model (aOR 0.69; 95% CI, 0.54-0.87; P = .0019; n = 6,145) and was consistent for recurrent ED visits (≥2 visits: aOR 0.54; 95% CI, 0.36-0.79; P = .0015). Receipt of care coordination was also associated with substantially lower odds of unmet healthcare needs (aOR 0.32; 95% CI, 0.23-0.45) and forgone mental health care (aOR 0.21; 95% CI, 0.13-0.33). The estimate for hospital stay was imprecise and included the null (aOR 0.61; 95% CI, 0.37-1.01; P = .053).Conclusion
Among US children with chronic physical pain who needed care coordination, receipt of needed care coordination was associated with lower odds of all-cause ED use and reported healthcare access gaps. These cross-sectional findings do not establish temporal ordering or causal effects and should be evaluated in prospective studies.
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BibTeX
@article{cheng2026receipt,
title = {{Receipt of needed care coordination and emergency department utilization among US children with chronic physical pain: a pooled analysis of the 2022-2024 National Survey of Children's Health.}},
author = {Tongming Cheng and Ziming Cai and Xiaonan Zhou and Ciai Lai and Lizhen Huang and Wei He},
journal = {Frontiers in pain research (Lausanne, Switzerland)},
year = {2026},
month = oct,
doi = {10.3389/fpain.2026.1994046},
url = {https://europepmc.org/article/MED/42908562},
note = {CC BY},
}
RIS
TY - JOUR
TI - Receipt of needed care coordination and emergency department utilization among US children with chronic physical pain: a pooled analysis of the 2022-2024 National Survey of Children's Health.
AU - Tongming Cheng
AU - Ziming Cai
AU - Xiaonan Zhou
AU - Ciai Lai
AU - Lizhen Huang
AU - Wei He
PY - 2026
DA - 2026/10/07
JO - Frontiers in pain research (Lausanne, Switzerland)
DO - 10.3389/fpain.2026.1994046
UR - https://europepmc.org/article/MED/42908562
AB - Background Children with chronic physical pain often require complex, multidisciplinary services across medical, behavioral, and community systems. However, whether receipt of needed care coordination is associated with acute healthcare utilization and care access in this population remains poorly characterized.Methods We conducted a pooled cross-sectional analysis of the 2022-2024 National Survey of Children's Health (NSCH). The analytic cohort included US children aged 6-17 years with caregiver-reported chronic physical pain who had an identified need for care coordination. The exposure was receipt of needed care coordination. The primary outcome was all-cause emergency department (ED) utilization (≥1 visit) in the prior 12 months. Survey-weighted multivariable logistic regression was used, with a minimally adjusted model (sociodemographic factors) and a fully adjusted model (additionally including insurance status, anxiety, depression, and functional difficulties) reported side by side.Results Among 6,326 eligible children (representing an average of 878,491 children annually), weighted 12-month ED visit rates were 29.0% (95% CI, 25.4%-32.5%) for those who received needed care coordination versus 40.0% (95% CI, 36.4%-43.7%) for those who did not. In the minimally adjusted model, receipt of needed care coordination was associated with lower odds of ED utilization (adjusted OR [aOR] 0.61; 95% CI, 0.48-0.76; P < .001; n = 6,310). This association persisted in the fully adjusted model (aOR 0.69; 95% CI, 0.54-0.87; P = .0019; n = 6,145) and was consistent for recurrent ED visits (≥2 visits: aOR 0.54; 95% CI, 0.36-0.79; P = .0015). Receipt of care coordination was also associated with substantially lower odds of unmet healthcare needs (aOR 0.32; 95% CI, 0.23-0.45) and forgone mental health care (aOR 0.21; 95% CI, 0.13-0.33). The estimate for hospital stay was imprecise and included the null (aOR 0.61; 95% CI, 0.37-1.01; P = .053).Conclusion Among US children with chronic physical pain who needed care coordination, receipt of needed care coordination was associated with lower odds of all-cause ED use and reported healthcare access gaps. These cross-sectional findings do not establish temporal ordering or causal effects and should be evaluated in prospective studies.
SN - 2673-561X
ER -