There is little association between prehospital delay, persistent symptoms, and post-discharge healthcare utilization in patients evaluated for acute coronary syndrome.

AIMS: Test for an association between prehospital delay for symptoms suggestive of acute coronary syndrome (ACS), persistent symptoms, and healthcare utilization (HCU) 30-days and 6-months post hospital discharge. BACKGROUND: Delayed treatment for ACS increases patient morbidity and mortality. Prehospital delay is the largest factor in delayed treatment for ACS. METHODS: Secondary analysis of data collected from a multi-center prospective study. Included were 722 patients presenting to the Emergency Department (ED) with symptoms that triggered a cardiac evaluation. Symptoms and HCU were measured using the 13-item ACS Symptom Checklist and the Froelicher's Health Services Utilization Questionnaire-Revised instrument. Logistic regression models were used to examine hypothesized associations. RESULTS: For patients with ACS (n = 325), longer prehospital delay was associated with fewer MD/NP visits (OR, 0.986) at 30 days. Longer prehospital delay was associated with higher odds of calling 911 for any reason (OR, 1.015), and calling 911 for chest related symptoms (OR, 1.016) 6 months following discharge. For non-ACS patients (n = 397), longer prehospital delay was associated with higher odds of experiencing chest pressure (OR, 1.009) and chest discomfort (OR, 1.008) at 30 days. At 6 months, longer prehospital delay was associated with higher odds of upper back pain (OR, 1.013), palpitations (OR 1.014), indigestion (OR, 1.010), and calls to the MD/NP for chest symptoms (OR, 1.014). CONCLUSIONS: There were few associations between prehospital delay and HCU for patients evaluated for ACS in the ED. Associations between prolonged delay and persistent symptoms may lead to increased HCU for those without ACS.

Examining the Relationship of Family Social Capital and Use of Pediatric Primary Health Care Services in the 2016-19 National Survey of Children's Health.

INTRODUCTION: This study examined the relationship of family social capital (FSC) and pediatric primary health care services (PHCU) among young children aged 0-5 years in the United States. FSC involves the interrelated contexts of child health and family characteristics. Understanding how this impacts PHCU may reveal important considerations for supporting access and use of essential health care services. METHOD: Using data from the 2016-19 National Survey of Children's Health (weighted N = 21,496,634), we conducted descriptive statistics and logistic regression to ascertain the relationship between FSC and PHCU. RESULTS: Statistically significant contributions included FSC (odds ratio [OR] = 1.2; confidence interval [CI] = 1.08-1.40), high school (OR = 0.49; CI = 2.65-5.39), and some college (OR = 0.72; CI = 0.62-0.85) DISCUSSION: Findings support that FSC and parent academic achievement impact PHCU. Interventions that foster family connection and parent adult health literacy may enhance PHCU.