Cooling the hot spots where child hospitalization rates are high: A neighborhood approach to population health

Health Aff

Improving population health requires a focus on neighborhoods with high rates of illness. We aimed to reduce hospital days for children from two high-morbidity, high-poverty neighborhoods in Cincinnati, Ohio, to narrow the gap between their neighborhoods and healthier ones. We also sought to use this population health improvement initiative to develop and refine a theory for how to narrow equity gaps across broader geographic areas. We relied upon quality improvement methods and a learning health system approach. Interventions included the optimization of chronic disease management; transitions in care; mitigation of social risk; and use of actionable, real-time data. The inpatient bed-day rate for the two target neighborhoods decreased by 18 percent from baseline (July 2012-June 2015) to the improvement phase (July 2015-June 2018). Hospitalizations decreased by 20 percent. There was no similar decrease in demographically comparable neighborhoods. We see the neighborhood as a relevant frame for achieving equity and building a multisector culture of health.

Beck AF, Anderson KL, Rich K, et al. Cooling the hot spots where child hospitalization rates are high: a neighborhood approach to population health. Health Aff (Millwood). 2019;38(9):1433-1441. PMID: 31479350. DOI: 10.1377/hlthaff.2018.05496.

Publication Year: 
Resource Type: 
Peer Reviewed Research
Study Design: 
Pre-post with Comparison Group
Social Determinant of Health: 
Economic Security
Not Specified
Children and Youth
Screening Research: