P3.168: Trends in Pediatric Emergency Room Utilization Rates in CenteringParenting Families Compared to Traditional Care: A Pilot Study in a Low Income Spanish-Speaking Population

Background: CenteringParenting is a model for well-child preventive care visits for infants up to 2 years old that combines components of a traditional well-visit with group sessions where families engage socially while discussing preventative care. This approach reinforces the idea that the primary care setting is not just a place for well-visits and vaccines, but can serve as a high-quality medical home. Patients with access to such a medical home, like CenteringParenting, are more likely to use available healthcare resources, reducing cost and labor burden in settings such as the emergency department (ED). Furthermore, low health literacy and social risk factors, like lack of insurance or access to care, can lead to increased ED utilization. This disproportionately impacts racial and ethnic minority populations, contributing to disparities in healthcare outcomes. Our study is the first to explore whether ED utilization behaviors differ between families receiving CenteringParenting compared to traditional care, in a primary care clinic serving predominantly Spanish-speaking, Medicaid-eligible families.

Methods: We conducted a pilot case-control study of pediatric patients aged 2–12 months in Neptune, NJ, from December 1, 2022, to December 1, 2023. The study group opted to receive CenteringParenting care, while matched controls received traditional care. Groups were compared by demographics such as race, ethnicity, preferred language and insurance coverage. The primary outcome was ED utilization between well visits, and the secondary outcome was the attendance rate at routine health visits. Fisher’s exact tests assessed associations between group and ED visits (as both count and dichotomized: ≤2 vs. ≥3). A Wilcoxon test compared well-visit attendance between groups. Significance was set at p< 0.05; no multiple testing adjustments were made due to the pilot nature of the study.

Results: We reviewed 174 encounters for 20 patients in the CenteringParenting group and 34 in the traditional care group. Groups were similar in race and insurance coverage. All participants were Spanish-speaking with ⅔ covered by Medicaid and ⅓ self-pay. The most common ethnicities were Mexican (52%) and Central/South American (18%). There was no significant association between group and the number of ED visits between well visits (p=0.38) or between group and dichotomized ED visits (≤2 vs. ≥3; p=0.29). However, CenteringParenting participants were significantly more likely to attend routine health visits (92.8% vs. 43.4%; p< 0.001) than those who received traditional care.

Conclusion: In this pilot study, we found no difference in ED utilization between routine health visits when comparing CenteringParenting and traditional care groups, in a clinic serving low-income, Spanish-speaking patients. However, we did find that well-visit attendance was significantly higher in the CenteringParenting group, supporting its role as a high-quality medical home for minority patients and families. Future studies with larger sample sizes are needed to further evaluate how the CenteringParenting model affects ED utilization.