OBJECTIVE Examine associations between hospital inclusivity (concordance between hospital/catchment demographics) and catchment area definition. PATIENT AND METHODS Cross-sectional study of patients (aged 0–19 years) with emergency department (ED) visits to a children’s hospital (2021–2022). Catchment was defined by (1) increasing geodesic distance from the hospital (1–100 km) and (2) farthest patient-contributing census tract. We calculated inclusivity scores for each race, ethnicity, and insurance subgroup. Positive scores indicated proportions of hospital patients in subgroups were greater than in the catchment. Data were sourced from electronic health records and American Community Survey. RESULTS Among 29 560 patients, race, ethnicity, and insurance inclusivity varied by catchment area. Difference in hospital and community proportions for patients with Black race were −10.8% at 5 km to 3.4% at 1 km, corresponding inclusivity scores −0.02 to 0.00; difference in proportions for patients with Hispanic/Latino ethnicity were −2.0% to 34.1%, corresponding inclusivity scores 0.00 to 0.12; difference in proportions for publicly insured patients were 18.7% to 36.9%, corresponding inclusivity scores 0.02 to 0.12. CONCLUSIONS Inclusivity is not a fixed hospital characteristic; for our pediatric ED, inclusivity scores changed with increasing catchment area. Research is needed to further investigate reliability of inclusivity scores across hospitals.
Henschel et al. (Wed,) studied this question.